John P Sullivan, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0064370 Issued in FL

Practice address

7740 Point Meadows Dr
Suite 3a
Jacksonville, FL 32256-9179

Phone

(904) 527-3577

Fax

(904) 527-3514

NPI assigned

Jul 22, 2005

Last updated

Apr 5, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

Creighton University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Retina Specialists PAGroup PAC ID 6305158650, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
• Memorial Satilla Health Hospital, Waycross, GA, CCN 110003

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsullivan@southeasternretina.intellechartdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeastern Retina Specialists, PA

  • Ophthalmology Physician
  • Jacksonville, FL
  • NPI 1427436187

  GA

  Medicare reassignment Care Compare group NPD
• Southeast Internal Medicine PC

  • Internal Medicine Physician
  • Waycross, GA
  • NPI 1104847607
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020
  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • St Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation
• Southeast Georgia Health Services, L.L.C.

  dba Memorial Satilla Health

  • Rural Acute Care Hospital
  • Waycross, GA
  • NPI 1922530468
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1619977345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7740 POINT MEADOWS DR",
            "address_2": "SUITE 3A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569179",
            "telephone_number": "904-527-3577",
            "fax_number": "904-527-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7740 POINT MEADOWS DR",
            "address_2": "SUITE 3A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569179",
            "telephone_number": "904-527-3577",
            "fax_number": "904-527-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0064370",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME64370",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "GA",
            "license": "37090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373365300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00578113A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gloria Cherish Hope Sullivan, CRNA
• Helen Sullivan, LDO
• Jacqueline Sullivan, BCBA
• John F. Sullivan, D.O.
• John Michael Sullivan, D.M.D, M.S.
• Kara Sullivan, DPT
• Kimberly Sullivan, LMT
• Luz Yorlady Sullivan, MD
• Matthew Sullivan, PA
• Michael Kevin Sullivan

• Ophthalmology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.