Lisa Renee Sullivan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601005958 Issued in MI

Practice address

44305 Harmony LN
Belleville, MI 48111-2449

Phone

(734) 716-5588

NPI assigned

Sep 14, 2010

Last updated

Jan 8, 2014By the provider in NPPES

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 MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Saint Joseph Mercy Livingston Hospital

  • Emergency Medicine Physician
  • Brighton, MI
  • NPI 1285753236

  Medical

  Medicare reassignment NPD
• Access Behavioral Care PLLC

  • Psychiatry Physician
  • Dearborn, MI
  • NPI 1174861959
  Medicare reassignment
• Behavioral Care Solutions for Adults and Seniors, Inc.

  • Psychiatry Physician
  • Novi, MI
  • NPI 1154727147
  Medicare reassignment
• Main Street Physicians P.C.

  • Internal Medicine Physician
  • Woodhaven, MI
  • NPI 1952866808
  Medicare reassignment
• St Joseph Mercy Hospital

  • Otolaryngology Physician
  • Ypsilanti, MI
  • NPI 1659499705
  Medicare reassignment
• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  NPD
• Saint Joseph Mercy Livingston Hospital

  • Clinical Pathology/Laboratory Medicine Physician
  • Brighton, MI
  • NPI 1730208778
  NPD
• St Joseph Mercy Hospital

  • Clinical Neuropsychologist
  • Ypsilanti, MI
  • NPI 1841318714
  NPD
• St Joseph Mercy Hospital

  • Cardiac Rehabilitation Clinic/Center
  • Ypsilanti, MI
  • NPI 1902359094
  NPD
• Insync Behavioral Health PLLC

  • Psychiatry Physician
  • New Baltimore, MI
  • NPI 1730563545
  NPD (past)
• Geriatric Psychiatric Services PLLC

  • Clinical Psychologist
  • Indianapolis, IN
  • NPI 1073753323
  NPD (past)

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1811205750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44305 HARMONY LN",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481112449",
            "telephone_number": "734-716-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44305 HARMONY LN",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481112449",
            "telephone_number": "734-716-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5601005958",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kristen Marie Stewart, LMSW
• Terrah Ranae Stewart, LPN
• Strategic Transtitions Consulting
• Christopher Suchyta
• Sumpter Community Clinic
• Sumpter Medical Care PLLC
• Sumpter Medical Care PLLC
• Sumpter Medical Group PLLC
• SVS Vision Inc (SVS Vision Optical Centers)

• Medical Physician Assistant in Belleville, MI
• Providers in Belleville, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.