Jessica A Sullivan, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016005718 Issued in IL

Practice address

1250 W Lake St
Ste 16
Addison, IL 60101-5744

Phone

(630) 543-3000

NPI assigned

May 3, 2016

Last updated

Aug 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica A Sieradzki Former name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Addison Podiatry Center PLLC

  • Foot & Ankle Surgery Podiatrist
  • Addison, IL
  • NPI 1790351757
  Medicare reassignment NPD Authorized official
• Louis J. Sanfilippo D.P.M. S.C.

  • Foot & Ankle Surgery Podiatrist
  • Addison, IL
  • NPI 1902072309
  NPD

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

• Alexian Brothers Medical Center

  • General Acute Care Hospital
  • Elk Grove Village, IL
  • NPI 1265577191
  Care Compare affiliation

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1750736195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W LAKE ST",
            "address_2": "STE 16",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601015744",
            "telephone_number": "630-543-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W LAKE ST",
            "address_2": "STE 16",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601015744",
            "telephone_number": "630-543-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SIERADZKI",
            "middle_name": "A",
            "credential": "D.P.M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Addison, IL
• Providers in Addison, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.