Paul B Sullivan, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Colfax, Washington. His current practice location is
1200 W Fairview St, Colfax, Washington. You can reach out to his office (for appointments etc.) via phone at
(509) 926-1770.
Paul B Sullivan is licensed to practice in Washington (license number AP30005473) 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 1023128451.
Provider's Profile
| Full Name | Paul B Sullivan |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 1200 W Fairview St, Colfax, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1023128451
- Provider Enumeration Date: 08/30/2006
- Last Update Date: 11/08/2016
Medicare PECOS Information:
- PECOS PAC ID: 1951291707
- Enrollment ID: I20110311000830
Medical Identifiers
Medical identifiers for Paul B Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023128451 | NPI | - | NPPES |
| 9617499 | Medicaid | WA | |
| 912153623 | Other | WA | TAX ID |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP30005473 (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. Paul B Sullivan allows following entities to bill medicare on his behalf.
| Entity Name | Public Hospital District No 3 Of Whitman County |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922009448
PECOS PAC ID: 7719875020
Enrollment ID: O20040309000090 |
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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. Paul B 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 |
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Paul B Sullivan, CRNA
21980 E Country Vista Dr, Ste 200,
Liberty Lake, WA 99019-6025
Ph: (509) 926-1770 | Paul B Sullivan, CRNA
1200 W Fairview St,
Colfax, WA 99111-9552
Ph: (509) 926-1770 |
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