Jessicca Ann Sullivan

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209024365 Issued in IL

Practice address

4885 Hoffman Blvd Ste 407
Hoffman Estates, IL 60192-3726

Phone

(224) 484-0183

NPI assigned

Mar 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates of Lagrange SCGroup PAC ID 7113830951, 19 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.78 of 100Reported as group

Quality

87.26

Promoting interoperability

100

Improvement activities

40

Cost

58.68

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00197

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

• Dermatology Associates of Lagrange SC

  • Dermatology Physician
  • La Grange Highlands, IL
  • NPI 1780795856
  Medicare reassignment Care Compare group NPD
• M D Aesthetics and Dermatology LLC

  • Dermatology Physician
  • Chicago, IL
  • NPI 1437678133
  NPD (past)

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1659028546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4885 HOFFMAN BLVD STE 400",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601923727",
            "telephone_number": "224-484-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4885 HOFFMAN BLVD STE 407",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601923726",
            "telephone_number": "224-484-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JESSICCA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209024365",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209024365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Marie Sufranski, M.S., R.D., L.D.N.
• Jinhwa Lee Suh, D.C.
• Stephen J Sula, M.D.
• Sullivan Ostoich Eye Care LTD
• Claire Anne Sullivan, FNLP, CFNC
• John F. Sullivan, DO
• Sunflower Therapy LLC
• Sunita Talwar MDSC
• Support Home Health Care LLC
• Surgical Care Center of Hoffman Estates PC

• Nurse Practitioner in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.