Anthony Michael Sullivan, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Canon City, Colorado. He graduated from healthcare school in 2004 and has 21 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Sondermind Provider Network Llc and his current practice location is
3225 Independence Rd, Canon City, Colorado. You can reach out to his office (for appointments etc.) via phone at
(719) 275-2351.
Anthony Michael Sullivan is licensed to practice in Colorado (license number 3490) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1245362615.
Healthcare Provider's Profile
| Full Name | Anthony Michael Sullivan |
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| Gender | Male |
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| Speciality | Clinical Psychologist |
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| Experience | 21 Years |
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| Location | 3225 Independence Rd, Canon City, Colorado |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Anthony Michael Sullivan graduated from medical school in 2004
NPI Data:
- NPI Number: 1245362615
- Provider Enumeration Date: 03/12/2007
- Last Update Date: 07/29/2020
Medicare PECOS Information:
- PECOS PAC ID: 5496934218
- Enrollment ID: I20110126000517
Medical Identifiers
Medical identifiers for Anthony Michael Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245362615 | NPI | - | NPPES |
| 26350246 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 2778 (Colorado) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 3490 (Colorado) | 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. Anthony Michael Sullivan allows following entities to bill medicare on his behalf.
| Entity Name | Sondermind Provider Network Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760854442
PECOS PAC ID: 9537572490
Enrollment ID: O20210113002826 |
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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. Anthony Michael 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 |
|---|
Anthony Michael Sullivan, PSYD
3225 Independence Rd,
Canon City, CO 81212-9380
Ph: (719) 275-2351 | Anthony Michael Sullivan, PSYD
3225 Independence Rd,
Canon City, CO 81212-9380
Ph: (719) 275-2351 |
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