Jessica Marie Sullivan, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Sarasota, Florida. Her current practice location is
6497 Parkland Dr Ste A, Sarasota, Florida. You can reach out to her office (for appointments etc.) via phone at
(941) 681-8260.
Jessica Marie Sullivan is licensed to practice in Florida (license number PY10510) 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 1336448984.
Healthcare Provider's Profile
| Full Name | Jessica Marie Sullivan |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 6497 Parkland Dr Ste A, Sarasota, Florida |
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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: 1336448984
- Provider Enumeration Date: 03/22/2011
- Last Update Date: 08/30/2022
Medicare PECOS Information:
- PECOS PAC ID: 3173996881
- Enrollment ID: I20230228001928
Medical Identifiers
Medical identifiers for Jessica Marie Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1336448984 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | PY10510 (Florida) | 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. Jessica Marie Sullivan allows following entities to bill medicare on her behalf.
| Entity Name | Dr. Crosby And Associates, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891338943
PECOS PAC ID: 0446623151
Enrollment ID: O20230228001860 |
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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. Jessica 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 |
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Jessica Marie Sullivan, PSYD
6497 Parkland Dr Ste A,
Sarasota, FL 34243-4097
Ph: (941) 681-8260 | Jessica Marie Sullivan, PSYD
6497 Parkland Dr Ste A,
Sarasota, FL 34243-4097
Ph: (941) 681-8260 |
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