Individual provider Active NPI

James Chester Sullivan, O.D.

  • Optometrist
  • Pasco, WA
National Provider Identifier
1992802656
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00004061 Issued in WA
Practice address
2715 W Court St
Pasco, WA 99301-3911
Phone
(509) 547-8409
Fax
(509) 544-7875
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00004061 WA Primary

Addresses

Primary practice location

2715 W Court St
Pasco, WA 99301-3911

Mailing address

2715 W Court St
Pasco, WA 99301-3911
Phone (509) 547-8409

Other identifiers 3

IdentifierTypeStateIssuer
0222797OtherWADEPT OF LABOR & INDUSTRY
2033561MedicaidWA
P00425941OtherWARAILROAD MEDICARE

Other names 1

  • Dr. J.C. Sullivan Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000334 WA Practitioner - Optometry 6002907243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pasco Vision Clinic P SGroup PAC ID 2860484169, 3 clinicians

Practice addresses (Care Compare)

2715 W Court St
Pasco, WA 99301-3911
Phone (509) 547-8409

Merit-based Incentive Payment System (MIPS)

Final score
84.3 of 100Reported as group
Quality
66.19
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pasco Vision Clinic P S Optometrist CurrentSince Aug 1, 2007 Accepting new patients

Locations

1906 N 20th Ave
Pasco, WA 99301
Phone (509) 547-8409

2715 W Court St
Pasco, WA 99301
Phone (509) 547-8409

Interoperability endpoints

  • Direct secure messaging: james.sullivan@direct.revolutionehr.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1992802656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 W COURT ST",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993013911",
            "telephone_number": "509-547-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 W COURT ST",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993013911",
            "telephone_number": "509-547-8409",
            "fax_number": "509-544-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JAMES",
        "middle_name": "CHESTER",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00004061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRY",
            "identifier": "0222797",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2033561",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00425941",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.C.",
            "last_name": "SULLIVAN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pasco, WA

Sources for this page

Verify at the official NPI Registry.