Kelly Sullivan, CRNP in Warren, PA - Medicare Nurse Practitioner

Kelly Sullivan, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Warren, Pennsylvania. Her current practice location is 2 W Crescent Park, Warren, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (814) 723-3300.

Kelly Sullivan is licensed to practice in Pennsylvania (license number SP015625) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114392735.

Contact Information

	Kelly Sullivan, CRNP
	2 W Crescent Park, Warren, PA 16365-2111
	(814) 723-3300
	(814) 726-9412

Map and Direction

Provider's Profile

Full Name	Kelly Sullivan
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2 W Crescent Park, Warren, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114392735
Provider Enumeration Date: 12/08/2015
Last Update Date: 10/03/2018

Medicare PECOS Information:

PECOS PAC ID: 7416253273
Enrollment ID: I20160304001313

Medical Identifiers

Medical identifiers for Kelly Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114392735	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
364SF0001X	Clinical Nurse Specialist - Family Health	SP015625 (Pennsylvania)	Secondary
363LF0000X	Nurse Practitioner - Family	SP015625 (Pennsylvania)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Sullivan allows following entities to bill medicare on her behalf.

Entity Name	Pennsylvania Department Of Human Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790768471 PECOS PAC ID: 0547168064 Enrollment ID: O20041207000650

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Sullivan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kelly Sullivan, CRNP 2 W Crescent Park, Warren, PA 16365-2111 Ph: (814) 723-3300	Kelly Sullivan, CRNP 2 W Crescent Park, Warren, PA 16365-2111 Ph: (814) 723-3300

Reviews and Comments

Nurse Practitioner Nurses in Warren, PA

Kelly Allen, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 514 W 3rd Ave, Warren, PA 16365 Phone: 814-723-2219 Fax: 814-723-9127
Mrs. Melissa Eckman, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2 W Crescent Park, Warren, PA 16365 Phone: 814-723-0407 Fax: 814-726-9412
Mrs. Amy R Ordiway, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 808 Pennsylvania Ave W, Warren, PA 16365 Phone: 814-723-6550
Mrs. Regan Nicole Olsen, MSN, BSN, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2 W Crescent Park, Warren, PA 16365 Phone: 814-723-3300
Kathleen Jane Leigh-simms, ANP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2 Crescent Park W, Warren, PA 16365 Phone: 814-723-3300 Fax: 814-726-9412
Shelby Chimiak, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3 Farm Colony Dr, Warren, PA 16365 Phone: 866-682-3250
Tracey E Mercer-benson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2817 Market St, Warren, PA 16365 Phone: 814-723-3794

Kelly Sullivan, CRNP - Medicare Nurse Practitioner in Warren, PA