Mark T Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

205 Issued in MT

Practice address

2900 12TH Ave N
Suite 140W
Billings, MT 59101-7506

Phone

(406) 238-6540

Fax

(406) 238-6599

NPI assigned

Aug 19, 2005

Sex

Male

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 4

Medicare fee-for-service enrollment

Enrolled in TX, MT2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ortho Montana, PSCGroup PAC ID 5193627404, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health St Vincent Regional Hospital Hospital, Billings, MT, CCN 270049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.sullivan@1146.chartlogic.direct-ci.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.

• Ortho Montana, PSC

  • Orthopaedic Surgery Physician
  • Billings, MT
  • NPI 1174515878
  Medicare reassignment Care Compare group
• US Health Dept of Health & Human Services

  • Rural Health Clinic/Center
  • Poplar, MT
  • NPI 1972694602

  TX

  Medicare reassignment
• Ortho Montana, PSC

  • Orthopaedic Surgery Physician
  • Billings, MT
  • NPI 1750601878
  NPD
• U S Health Dept of Health & Human Services

  • Critical Access Hospital
  • Lodge Grass, MT
  • NPI 1750410395
  NPD
• US Health Dept of Health & Human Services

  • Critical Access Hospital
  • Crow Agency, MT
  • NPI 1548393358
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

• SCL Health Montana

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1083655997
  Care Compare affiliation
• St. Vincent Healthcare

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1396916276
  Care Compare affiliation

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1952393514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N",
            "address_2": "SUITE 140W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017506",
            "telephone_number": "406-238-6540",
            "fax_number": "406-238-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N",
            "address_2": "SUITE 140W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017506",
            "telephone_number": "406-238-6540",
            "fax_number": "406-238-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARK",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970010277",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435438",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "000900883",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119184500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zijie Su, MD, MPH
• Lindsey Marie Suchy, MS, LCPC
• Kae M Sukut, PA-C
• Brian M. Sullivan, PAC
• Lindsay Renee Sullivan
• Michael Sullivan, MSW, LCSW
• Bree Nicole Summers, LCPC
• Summit Healing Center, P.C.
• Summit Oral Surgery & Implant Center
• Summit Therapy Center PC

• Physician Assistant in Billings, MT
• Providers in Billings, MT by specialty
• Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.