Dr Kevin L Sullivan, MD in Decatur, GA

Dr Kevin L Sullivan, MD is a medicare enrolled "Radiology - Vascular & Interventional Radiology" physician in Decatur, Georgia. His current practice location is 250 Ponce De Leon Ave, Suite 100, Decatur, Georgia. You can reach out to his office (for appointments etc.) via phone at (404) 377-9171.

Dr Kevin L Sullivan is licensed to practice in Georgia (license number 053430) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1447276225.

Contact Information

	Dr Kevin L Sullivan, MD
	250 Ponce De Leon Ave, Suite 100, Decatur, GA 30030-3406
	(404) 377-9171
	(404) 377-9172

Map and Direction

Physician's Profile

Full Name	Dr Kevin L Sullivan
Gender	Male
Speciality	Radiology - Vascular & Interventional Radiology
Location	250 Ponce De Leon Ave, Decatur, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447276225
Provider Enumeration Date: 07/14/2006
Last Update Date: 07/27/2012

Medicare PECOS Information:

PECOS PAC ID: 8325952427
Enrollment ID: I20031113000443

Medical Identifiers

Medical identifiers for Dr Kevin L Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447276225	NPI	-	NPPES
409020411I	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	MD027085E (Pennsylvania)	Secondary
2085R0204X	Radiology - Vascular & Interventional Radiology	MD027085E (Pennsylvania)	Secondary
2085R0204X	Radiology - Vascular & Interventional Radiology	053430 (Georgia)	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. Dr Kevin L Sullivan allows following entities to bill medicare on his behalf.

Entity Name	Preferred Vascular Services Northwest Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598037822 PECOS PAC ID: 1850552142 Enrollment ID: O20120413000013

Entity Name	Preferred Vascular Services Southeast Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861992976 PECOS PAC ID: 3577812312 Enrollment ID: O20180828000280

Entity Name	Preferred Vascular Services Southwest
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790285229 PECOS PAC ID: 0446502918 Enrollment ID: O20181010003246

Entity Name	Preferred Vascular Services Macon Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437659455 PECOS PAC ID: 6406108984 Enrollment ID: O20181010003906

Entity Name	Preferred Vascular Services Northeast
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780184218 PECOS PAC ID: 3577815695 Enrollment ID: O20181017002434

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. Dr Kevin L 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
Dr Kevin L Sullivan, MD 182 Industrial Road, Glen Rock, PA 17327-8626 Ph: (717) 235-9352	Dr Kevin L Sullivan, MD 250 Ponce De Leon Ave, Suite 100, Decatur, GA 30030-3406 Ph: (404) 377-9171

Reviews and Comments

Radiology Doctors in Decatur, GA

Dr. Kendra Marshae Franklin, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1670 Clairmont Rd, Department Of Radiology, Atlanta Va Medical Center, Decatur, GA 30033 Phone: 404-321-6111
Gigi B Schemankewitz, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1670 Clairmont Rd, Decatur, GA 30033 Phone: 404-321-6111
Ashish B Patel, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2675 N Decatur Rd Ste G09, Decatur, GA 30033 Phone: 404-501-6925 Fax: 404-501-6930
Dr. John Seahhong Wong, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1670 Clairmont Rd, Decatur, GA 30033 Phone: 404-321-6111 Fax: 404-728-7648
Sandra L Ridings-hesser, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 496 Medlock Rd Lowr Level, Decatur, GA 30030 Phone: 404-687-8649 Fax: 404-745-0907
Greta Jane Sybers, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1670 Clairmont Rd, Veteran's Affairs Medical Center, Decatur, GA 30033 Phone: 404-321-6111
Clifford M Kerley, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 2701 N Decatur Rd, Decatur, GA 30033 Phone: 404-564-5400 Fax: 404-564-5403

Dr Kevin L Sullivan, MD - Medicare Radiology in Decatur, GA