Individual provider Active NPI

Michael A Sullivan, MD

  • Diagnostic Radiology Physician
  • Covington, LA
National Provider Identifier
1790711760
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD.009718 Issued in LA
Practice address
1000 Ochsner Blvd
Covington, LA 70433-8107
Phone
(985) 875-2828
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD.009718 LA Primary

Addresses

Primary practice location

1000 Ochsner Blvd
Covington, LA 70433-8107

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other identifiers 2

IdentifierTypeStateIssuer
00012030MedicaidMS
1164674MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071017000221 LA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 1355437757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Tulane University School of Medicine, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1000 Ochsner Blvd
Covington, LA 70433-8107
Phone (985) 875-2828

104 Acadia Park Dr
Raceland, LA 70394-2618
Phone (985) 537-3211

111 C Robert E Lee Blvd
New Orleans, LA 70124-2534
Phone (504) 286-2004

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

1516 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3470

1625 Barataria Blvd
Suite a
Marrero, LA 70072-4308
Phone (504) 309-5015

16777 Medical Ctr Dr
Baton Rouge, LA 70816-3254
Phone (225) 754-3278

180 W Esplanade Ave
Ochsner Clinic Kenner
Kenner, LA 70065-2467
Phone (504) 842-4000

2215 Veterans Memorial Blvd
Metairie, LA 70002-6322
Phone (504) 838-3524

2820 Napoleon Ave
New Orleans, LA 70115-6969
Phone (504) 842-5300

3417 Williams Blvd
Kenner, LA 70065-3725
Phone (504) 461-9660

4430 Veterans Memorial Blvd
Metairie, LA 70006-5329
Phone (504) 433-7203

4605 Magazine St
New Orleans, LA 70115-1517
Phone (504) 891-7676

5922 W Main St
Suite a
Houma, LA 70360-1715
Phone (985) 262-8015

71380 Hwy 21
Covington, LA 70433-7245
Phone (985) 661-3534

900 Magazine St
New Orleans, LA 70130-3814
Phone (504) 552-2433

9605 Jefferson Hwy
River Ridge, LA 70123-2550
Phone (504) 739-9494

Hospital & facility affiliations

  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
  • Ochsner Medical Center-Kenner Hospital, Kenner, LA, CCN 190274
  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.009718LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Jul 1, 1966 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 1, 1966 Accepting new patients

Locations

10310 The Grove Blvd
Baton Rouge, LA 70836
Phone (225) 761-5239

1000 Ochsner Blvd
Covington, LA 70433
Phone (985) 898-7051

180 W Esplanade Ave
Ste 8087
Kenner, LA 70065

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

1057 Paul Maillard Rd
Luling, LA 70070
Phone (985) 785-3655

1514 Jefferson Hwy
New Orleans, LA 70121

1516 Jefferson Hwy
New Orleans, LA 70121
Phone (504) 833-2337

2700 Napoleon Ave
New Orleans, LA 70115
Phone (504) 842-3650

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

2500 Belle Chasse Hwy
Terrytown, LA 70056
Phone (504) 391-5157

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1790711760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OCHSNER BLVD",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338107",
            "telephone_number": "985-875-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "MD.009718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00012030",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164674",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.