Michael Robert Sullivan, MSW is a medicare enrolled "Social Worker" provider in Spokane, Washington. His current practice location is
107 S Division St, Spokane, Washington. You can reach out to his office (for appointments etc.) via phone at
(509) 838-4651.
Michael Robert Sullivan is licensed to practice in Washington (license number LW61234841) 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 1003288796.
Healthcare Provider's Profile
| Full Name | Michael Robert Sullivan |
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| Gender | Male |
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| Speciality | Social Worker |
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| Location | 107 S Division St, Spokane, 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: 1003288796
- Provider Enumeration Date: 10/21/2015
- Last Update Date: 04/22/2022
Medicare PECOS Information:
- PECOS PAC ID: 7719371913
- Enrollment ID: I20220304001212
Medical Identifiers
Medical identifiers for Michael Robert Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003288796 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | CG60648868 (Washington) | Secondary |
| 104100000X | Social Worker | SC61158375 (Washington) | Secondary |
| 1041C0700X | Social Worker - Clinical | LW61234841 (Washington) | Secondary |
| 104100000X | Social Worker | LW61234841 (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. Michael Robert Sullivan allows following entities to bill medicare on his behalf.
| Entity Name | Frontier Behavioral Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861495327
PECOS PAC ID: 5092603340
Enrollment ID: O20040308001191 |
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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. Michael Robert 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 |
|---|
Michael Robert Sullivan, MSW
107 S Division St,
Spokane, WA 99202-1510
Ph: (509) 838-4651 | Michael Robert Sullivan, MSW
107 S Division St,
Spokane, WA 99202-1510
Ph: (509) 838-4651 |
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