Michael L Sullivan, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA3485 Issued in FL

Practice address

1540 S Tamiami TRL
Suite 303
Sarasota, FL 34239-2930

Phone

(941) 917-8791

Fax

(941) 917-8793

NPI assigned

Jul 12, 2006

Last updated

Apr 4, 2016By 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 1

Addresses

Other identifiers 3

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Wake Forest University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• SMH Physician Services Inc

  dba First Physicians Group

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292
  Medicare reassignment Care Compare group NPD
• Cardiothoracic Surgical Associates PA

  • Specialist
  • Largo, FL
  • NPI 1932160330
  NPD (past)
• SMH Physician Services Inc

  dba First Physicians Group

  • Gynecology Physician
  • Sarasota, FL
  • NPI 1275525826
  NPD (past)

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

• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1740205863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 S TAMIAMI TRL",
            "address_2": "SUITE 303",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392930",
            "telephone_number": "941-917-8791",
            "fax_number": "941-917-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA3485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261645900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y00N0",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer A Sullivan, NP
• Jessica Marie Sullivan, PSYD
• John E Sullivan Jr., M.D
• Kay Louise Sullivan, LMHC LPC
• Matthew Sean Sullivan, LMT
• Sumeet Bhanot MD PA (Bhanot Facial Plastic Surgery)
• Jonathan Antonio Summerlin, PHARMD
• Rachel Summerlin, PHARMD
• Jean Ellen Summers, MASSAGE THERAPIST
• Janice L Summersgill

• Surgical Physician Assistant in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.