John T Sullebarger, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

ME62629 Issued in FL

Practice address

4200 N Armenia Ave
Suite 5
Tampa, FL 33607-6438

Phone

(813) 284-2200

Fax

(813) 377-1700

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Cardiology

Education

Johns Hopkins University School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tampa General Hospital Hospital, Tampa, FL, CCN 100128
• St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Ohi West Medical Group II LLC

  • General Practice Physician
  • Zephyrhills, FL
  • NPI 1982381299
  Medicare reassignment Care Compare group NPD
• Florida Medical Clinic LLC

  • Clinic/Center
  • Zephyrhills, FL
  • NPI 1821055690
  Medicare reassignment NPD
• Florida Cardiovascular Institute PA

  • Cardiovascular Disease Physician
  • Tampa, FL
  • NPI 1447277322
  NPD (past) Authorized official
• Florida Medical Clinic, LLC

  • Pharmacy
  • Zephyrhills, FL
  • NPI 1669548020
  NPD
• Ohi West Medical Group II LLC

  • Durable Medical Equipment & Medical Supplies
  • Wesley Chapel, FL
  • NPI 1427814847
  NPD
• Ohi West Medical Group II LLC

  • Physiological Laboratory
  • Zephyrhills, FL
  • NPI 1679344394
  NPD (past)

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

• Florida Health Sciences Center Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  Care Compare affiliation
• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1346519816
  Care Compare affiliation
• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1881632818
  Care Compare affiliation

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1679516728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-528-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 N ARMENIA AVE",
            "address_2": "SUITE 5",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076438",
            "telephone_number": "813-284-2200",
            "fax_number": "813-377-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLEBARGER",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME62629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "17787",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370815200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cardst@flmed.directbygreenway.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4200 N Armenia Ave",
            "address_2": "Suite 5",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336076438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yashodra Ambica Sukhnandan
• Emilie Sukijbumrung
• Alexis Nicole Sukow
• Ada Elena Sulbaran Semprun, PA-C
• Hasan Suleiman, MD
• Andrea Sullivan, MCMHC
• Brent C Sullivan, MD
• Brittany Sullivan, DO
• Burton Henry Sullivan, SLP
• Daniel Sullivan, MD

• Interventional Cardiology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Interventional Cardiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.