Becky Lynn Sullivan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2056 Issued in KY

Practice address

3480 Yorkshire Medical Park
Lexington, KY 40509-1886

Phone

(859) 263-5140

Fax

(859) 263-5141

NPI assigned

Sep 2, 2015

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 UT

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

University of Kentucky College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heiden Orthopedics,LLCGroup PAC ID 2163589391, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Park City Hospital Hospital, Park City, UT, CCN 460057

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: bsullivan15538@bhkydirect.com

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.

• Heiden Orthopedics,LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Park City, UT
  • NPI 1386896652
  Medicare reassignment Care Compare group

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

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Park City, UT
  • NPI 1851530984
  Care Compare affiliation

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1780051110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 YORKSHIRE MEDICAL PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091886",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 YORKSHIRE MEDICAL PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091886",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1868 Plaudit Pl",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092429",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "145 Newcomb Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "KY",
            "postal_code": "404562728",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 Yorkshire Medical Park",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092513",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Windsor Path",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "KY",
            "postal_code": "403249617",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Cynthia Dr Ste 139",
            "address_purpose": "LOCATION",
            "city": "Nicholasville",
            "state": "KY",
            "postal_code": "403568062",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Hail Knob Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425033418",
            "country_code": "US",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BECKY",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100387430",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Michelle Sugarman, MD
• Antoine Suggs, CSFA
• Jeremiah Suhl, MD
• Wafa A Suleiman
• Yousef Suleiman
• Christina Marie Sullivan, M.D.
• Clarence Francis Sullivan III, PHARMD
• Daniel James Sullivan, DO
• Diana Renee Sullivan, RN
• Kelly Sue Sullivan

• Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.