Active NPI
Elise Sullivan
- Family Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2019044085
- Practice address
- 3635 Vista Ave
Saint Louis, MO 63110-2539 - Phone
- (314) 268-5558
- NPI assigned
- Sep 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2019044085 | MO | Primary |
Addresses
Primary practice location
3635 Vista Ave
Saint Louis, MO 63110-2539
Mailing address
2763 Tiara Dr
Arnold, MO 63010-3027
Phone (314) 517-6078
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Saint Louis University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000
1225 S Grand Blvd
Saint Louis, MO 63104-1016
641 N New Ballas Rd
Creve Coeur, MO 63141-6713
Phone (314) 888-4647
9556 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 961-2255
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.94 of 100
- Quality
- 68.52
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.22
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019044085 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Access Urgent Care, PC | Family Medicine | Current | Accepting new patients |
| SSM Health Care Group | Current | Accepting new patients | |
| STL Interventional Oncology Interventional Radiology Clinics LLC | Current | Accepting new patients | |
| Total Access Urgent Care, PC | Current | Accepting new patients | |
| SSM Health Care Group | Family Medicine | Current | Accepting new patients |
| SSM Medical Group Inc. | Past | Accepting new patients |
Locations
3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101
9556 Manchester Rd
Saint Louis, MO 63119
Phone (314) 373-5740
1225 S Grand Blvd
Fl 3
Saint Louis, MO 63104
Phone (314) 257-3760
641 N New Ballas Rd
Saint Louis, MO 63141
Phone (314) 648-0101
3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
1717 Madison Ave
Washington, MO 63090
Phone (636) 244-6950
Interoperability endpoints
- esullivan345428@direct-ehr-ssmhc.com
Organizations & group practices 6
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.
-
dba SLUCare Physician Group
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1306589544
Family Medicine
-
dba STL IOIR Clinics
- Vascular & Interventional Radiology Physician
- Creve Coeur, MO
- NPI 1558240960
-
dba Total Access Urgent Care
- Urgent Care Clinic/Center
- Saint Louis, MO
- NPI 1962684886
-
dba SLUCare Physician Group
- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
dba Total Access Urgent Care
- Urgent Care Clinic/Center
- Saint Louis, MO
- NPI 1952729402
Family Medicine
-
dba SSM Health Medical Group
- Durable Medical Equipment & Medical Supplies
- Fenton, MO
- NPI 1124579966
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba SSM Health Saint Louis University Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1942685920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1932750874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2763 TIARA DR",
"city": "ARNOLD",
"state": "MO",
"postal_code": "630103027",
"telephone_number": "314-517-6078",
"fax_number": "314-268-5786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3635 VISTA AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102539",
"telephone_number": "314-268-5558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "ELISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-23",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2019044085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.