Sheila Kerri Sullivan, D.O.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

61084-21 Issued in WI

Practice address

123 Hospital Drive
Suite 1002
Watertown, WI 53098-3320

Phone

(920) 261-8225

Fax

(920) 261-5343

NPI assigned

May 7, 2010

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 WI

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

Specialty

Ophthalmology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Watertown Physician Practices LLCGroup PAC ID 8022329408, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116
• Fort Memorial Hospital Hospital, Fort Atkinson, WI, CCN 520071
• Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sheila.sullivan.1@17022.direct.athenahealth.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.

• Watertown Physician Practices LLC

  • Family Medicine Physician
  • Watertown, WI
  • NPI 1770964363
  Medicare reassignment Care Compare group NPD
• Watertown Physician Practices LLC

  • Obstetrics & Gynecology Physician
  • Watertown, WI
  • NPI 1225412265

  Ophthalmology

  NPD

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

• Fort Healthcare Inc

  • Otolaryngology Physician
  • Fort Atkinson, WI
  • NPI 1417993361

  Hospital

  Care Compare affiliation
• Fort Healthcare, Inc.

  • General Acute Care Hospital
  • Fort Atkinson, WI
  • NPI 1811916281
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Oconomowoc, WI
  • NPI 1366420531
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  • Community/Retail Pharmacy
  • Oconomowoc, WI
  • NPI 1497942205

  Hospital

  Care Compare affiliation
• Watertown Medical Center LLC

  • General Acute Care Hospital
  • Watertown, WI
  • NPI 1992776041
  Care Compare affiliation

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

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1992023493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DRIVE",
            "address_2": "SUITE 1002",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983320",
            "telephone_number": "920-261-8225",
            "fax_number": "920-261-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DRIVE",
            "address_2": "SUITE 1002",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983320",
            "telephone_number": "920-261-8225",
            "fax_number": "920-261-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHEILA",
        "middle_name": "KERRI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-07",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "61084-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992023493",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Souksavath Strese, RN
• Sherry Ann Strupp, PT
• David F Stuebe, PT
• Gina Marie Sullivan, APNP
• Michael E Sullivan, M.D.
• Jeffrey Sundberg, D.D.S.
• Mary Supple, LPN
• Meghan Marie Supple
• Promporn June Suwanabol
• Zachary Thomas Sweatman, ATC

• Ophthalmology Physician in Watertown, WI
• Providers in Watertown, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.
• 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.