Lisa Marie Sullivan, APRN-CNP in Yukon, OK - Medicare Nurse Practitioner

Lisa Marie Sullivan, APRN-CNP is a medicare enrolled "Nurse Practitioner - Primary Care" in Yukon, Oklahoma. Her current practice location is 1491 Health Center Pkwy, Yukon, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (405) 806-2200.

Lisa Marie Sullivan is licensed to practice in Oklahoma (license number 220736) 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 1063255164.

Contact Information

	Lisa Marie Sullivan, APRN-CNP
	1491 Health Center Pkwy, Yukon, OK 73099-6492
	(405) 806-2200
	(405) 806-2207

Map and Direction

Provider's Profile

Full Name	Lisa Marie Sullivan
Gender	Female
Speciality	Nurse Practitioner - Primary Care
Location	1491 Health Center Pkwy, Yukon, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063255164
Provider Enumeration Date: 06/17/2024
Last Update Date: 12/26/2024

Medicare PECOS Information:

PECOS PAC ID: 2163951286
Enrollment ID: I20250130000604

Medical Identifiers

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

Identifier	Type	State	Issuer
1063255164	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP2300X	Nurse Practitioner - Primary Care	220736 (Oklahoma)	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. Lisa Marie Sullivan allows following entities to bill medicare on her behalf.

Entity Name	Aquilo Health Company P C Dba Canadian Valley Family Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891869822 PECOS PAC ID: 8224016480 Enrollment ID: O20040713000843

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. Lisa Marie 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
Lisa Marie Sullivan, APRN-CNP 7617 Nw 25th St, Bethany, OK 73008-4915 Ph: (405) 226-0767	Lisa Marie Sullivan, APRN-CNP 1491 Health Center Pkwy, Yukon, OK 73099-6492 Ph: (405) 806-2200

Reviews and Comments

Nurse Practitioner Nurses in Yukon, OK

Rhonda Mose, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11900 Nw Expressway, Yukon, OK 73099 Phone: 405-283-9300 Fax: 405-283-9301
Mr. Zachary Adam Smith, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1445 Health Center Pkwy, Yukon, OK 73099 Phone: 405-577-6701
Priya John, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 900 Justin Dr, Yukon, OK 73099 Phone: 405-473-3058
Allison Diane Henrichs, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1501 S Ranchwood Blvd, Yukon, OK 73099 Phone: 405-914-6634 Fax: 405-914-6693
Angie Osborn, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1501 S Ranchwood Blvd Ste 203, Yukon, OK 73099 Phone: 405-914-6634 Fax: 405-914-6693
Amanda Oblander, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 520 S Mustang Rd, Yukon, OK 73099 Phone: 405-936-5910 Fax: 405-577-2605

Lisa Marie Sullivan, APRN-CNP - Medicare Nurse Practitioner in Yukon, OK