Jon M Sullivan, MD in Gallipolis, OH

Jon M Sullivan, MD is a medicare enrolled "Pediatrics" physician in Gallipolis, Ohio. His current practice location is 100 Jackson Pike, Gallipolis, Ohio. You can reach out to his office (for appointments etc.) via phone at (740) 446-5371.

Jon M Sullivan is licensed to practice in Ohio (license number 35-05-4754) 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 1053341370.

Contact Information

	Jon M Sullivan, MD
	100 Jackson Pike, Gallipolis, OH 45631-1560
	(740) 446-5371
	(740) 446-5711

Map and Direction

Physician's Profile

Full Name	Jon M Sullivan
Gender	Male
Speciality	Pediatrics
Location	100 Jackson Pike, Gallipolis, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053341370
Provider Enumeration Date: 07/03/2006
Last Update Date: 12/29/2020

Medicare PECOS Information:

PECOS PAC ID: 9830168806
Enrollment ID: I20070803000587

Medical Identifiers

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

Identifier	Type	State	Issuer
1053341370	NPI	-	NPPES
000000181879	Other	OH	UNISON MEDICAID #
001714064	Other		MOUNTAIN STATE BCBS
0882719	Other	OH	MOLINA MEDICAID #
000000006810	Other	WV	ANTHEM BCBS
370002760	Other	OH	RR MEDICARE
000000007592	Other		ANTHEM BCBS
0107833000	Medicaid	WV
0882719	Medicaid	OH
310917085065	Other	OH	CARESOURCE MEDICAID #

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	16987 (West Virginia)	Secondary
208000000X	Pediatrics	35-05-4754 (Ohio)	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. Jon M Sullivan allows following entities to bill medicare on his behalf.

Entity Name	Holzer Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508817248 PECOS PAC ID: 5890606008 Enrollment ID: O20031215000746

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. Jon M 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
Jon M Sullivan, MD 90 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5371	Jon M Sullivan, MD 100 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5371

Reviews and Comments

Pediatrics Doctors in Gallipolis, OH

Jonathan Mathis, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 855-446-5937 Fax: 740-446-5711
Mr. Jacob Lawrence Pessia, MS IV Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-441-1949 Fax: 740-446-5982
Shana Allie Vore, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 855-446-5937 Fax: 740-446-5711
Pradeep K. Kandula, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5371 Fax: 740-446-5711
Danielle T. Cappelletti, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5371 Fax: 740-446-5711
Il H. Kim, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5371 Fax: 740-446-5711

Jon M Sullivan, MD - Medicare Pediatrics in Gallipolis, OH