Kellen A Sullivan, MD in Salt Lake City, UT - Medicare Internal Medicine

Kellen A Sullivan, MD is a medicare enrolled "Internal Medicine" physician in Salt Lake City, Utah. She went to Ohio State University College Of Medicine and graduated in 2019 and has 5 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Legacy Salmon Creek Hospital and her current practice location is 30 N 1900 E Rm 4c116, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 581-7606.

Kellen A Sullivan is licensed to practice in Utah (license number 11898972-1205) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1003479270.

Contact Information

	Kellen A Sullivan, MD
	30 N 1900 E Rm 4c116, Salt Lake City, UT 84132-0002
	(801) 581-7606
	Not Available

Map and Direction

Physician's Profile

Full Name	Kellen A Sullivan
Gender	Female
Speciality	Internal Medicine
Experience	5 Years
Location	30 N 1900 E Rm 4c116, Salt Lake City, Utah
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kellen A Sullivan attended and graduated from Ohio State University College Of Medicine in 2019

NPI Data:

NPI Number: 1003479270
Provider Enumeration Date: 04/15/2019
Last Update Date: 08/24/2020

Medicare PECOS Information:

PECOS PAC ID: 5991123556
Enrollment ID: I20220622002957

Medical Identifiers

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

Identifier	Type	State	Issuer
1003479270	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	11898972-1205 (Utah)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Legacy Salmon Creek Medical Center	Vancouver, WA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Legacy Salmon Creek Hospital	0446295711	223

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. Kellen A Sullivan allows following entities to bill medicare on her behalf.

Entity Name	Legacy Salmon Creek Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356357784 PECOS PAC ID: 0446295711 Enrollment ID: O20051223000194

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. Kellen A 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
Kellen A Sullivan, MD 30 N 1900 E Rm 4c116, Salt Lake City, UT 84132-0002 Ph: (801) 581-7606	Kellen A Sullivan, MD 30 N 1900 E Rm 4c116, Salt Lake City, UT 84132-0002 Ph: (801) 581-7606

Reviews and Comments

Internal Medicine Doctors in Salt Lake City, UT

Dr. Mehmet Akkaya, M.D Internal Medicine Medicare: Medicare Enrolled Practice Location: University Of Utah Hospital Cardiology, 3o N,1900 E, Rm:4a100, Salt Lake City, UT 84132 Phone: 801-505-1689
Dr. Willard Dere, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 500 Foothill Blvd, Salt Lake City, UT 84148 Phone: 801-582-1565
Megan Meier, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-581-2121
Joel Money, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-581-2121
Mchale O. Anderson, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 30 N 1900 E Rm 4a100, Salt Lake City, UT 84132 Phone: 801-587-2451
Siddharth K. Iyengar, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 30 N 1900 E Rm 4c116, Salt Lake City, UT 84132 Phone: 801-581-7606
Taryn A. Young, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 5121 S Cottonwood St, Salt Lake City, UT 84107 Phone: 801-507-4384 Fax: 801-507-4398

Kellen A Sullivan, MD - Medicare Internal Medicine in Salt Lake City, UT