Amy E Sullivan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

797 Issued in NV

Practice address

1050 Hanson St
Winnemucca, NV 89445-2774

Phone

(756) 253-9377

Fax

(775) 625-3938

NPI assigned

Oct 19, 2011

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Optometry

Education

Pacific University - College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amy E Sullivan LLCGroup PAC ID 5799172557, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

10.83 of 100Reported as individual

Quality

21.67

Improvement activities

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Amy E Sullivan LLC

  • Optometrist
  • Winnemucca, NV
  • NPI 1720734155
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1699050740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 HANSON ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894452774",
            "telephone_number": "756-253-9377",
            "fax_number": "775-625-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 HANSON ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894452774",
            "telephone_number": "756-253-9377",
            "fax_number": "775-625-3938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 S Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895091504",
            "country_code": "US",
            "telephone_number": "775-323-0157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9700 S McCarran Blvd",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895239203",
            "country_code": "US",
            "telephone_number": "775-827-3937",
            "fax_number": "775-746-5316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699050740",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• State of Nevada
• Vanessa Stickney
• Marie Stone
• Angela Street
• Charles Adnan Stringham, M.D.
• Kalie Ann Sullivan
• Dawn Swanson
• Robert Sweeten, DPT
• Nathan Ezra Swensen, D.M.D
• Melanie Taylor Thurmond, DPT

• Optometrist in Winnemucca, NV
• Providers in Winnemucca, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.