Mr Kevin Doerr Sullivan, PA is a medicare enrolled "Physician Assistant" in Ione, Washington. His current practice location is
208 Cedar Creek Ter, Ione, Washington. You can reach out to his office (for appointments etc.) via phone at
(509) 442-3514.
Mr Kevin Doerr Sullivan is licensed to practice in Washington (license number PA60716898) 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 1356886998.
Provider's Profile
| Full Name | Mr Kevin Doerr Sullivan |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 208 Cedar Creek Ter, Ione, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1356886998
- Provider Enumeration Date: 01/05/2017
- Last Update Date: 02/24/2017
Medicare PECOS Information:
- PECOS PAC ID: 5395029771
- Enrollment ID: I20170302001436
Medical Identifiers
Medical identifiers for Mr Kevin Doerr Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1356886998 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363A00000X | Physician Assistant | TA60724212 (Washington) | Secondary |
| 363A00000X | Physician Assistant | PA60716898 (Washington) | 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. Mr Kevin Doerr Sullivan allows following entities to bill medicare on his behalf.
| Entity Name | New Health Programs Association |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679537575 PECOS PAC ID: 1951202373 Enrollment ID: O20040119000412 |
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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. Mr Kevin Doerr 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 |
Mr Kevin Doerr Sullivan, PA 208 Cedar Creek Ter, Ione, WA 99139-5011 Ph: (509) 442-3514 | Mr Kevin Doerr Sullivan, PA 208 Cedar Creek Ter, Ione, WA 99139-5011 Ph: (509) 442-3514 |
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