Dr Fred M Sullivan Jr, MD in Shreveport, LA

Dr Fred M Sullivan Jr, MD is a medicare enrolled "Pediatrics" physician in Shreveport, Louisiana. His current practice location is 1501 Kings Hwy, Shreveport, Louisiana. You can reach out to his office (for appointments etc.) via phone at (318) 675-5000.

Dr Fred M Sullivan Jr is licensed to practice in Louisiana (license number 016881) 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 1841396611.

Contact Information

	Dr Fred M Sullivan Jr, MD
	1501 Kings Hwy, Shreveport, LA 71103-4228
	(318) 675-5000
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Fred M Sullivan Jr
Gender	Male
Speciality	Pediatrics
Location	1501 Kings Hwy, Shreveport, Louisiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1841396611
Provider Enumeration Date: 09/16/2006
Last Update Date: 05/15/2012

Medicare PECOS Information:

PECOS PAC ID: 0345257713
Enrollment ID: I20060309000107

Medical Identifiers

Medical identifiers for Dr Fred M Sullivan Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1841396611	NPI	-	NPPES
1345261	Medicaid	LA
5M257F600	Other	LA	MEDICARE - PTAN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	016881 (Louisiana)	Primary
207P00000X	Emergency Medicine	016881 (Louisiana)	Secondary

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. Dr Fred M Sullivan Jr allows following entities to bill medicare on his behalf.

Entity Name	Lsu Health Sciences Center Shreveport Faculty Group Practice
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013374222 PECOS PAC ID: 4082902721 Enrollment ID: O20161012000307

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. Dr Fred M Sullivan Jr 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
Dr Fred M Sullivan Jr, MD 1512 W Kirby Pl, Shreveport, LA 71103-3822 Ph: (318) 675-7636	Dr Fred M Sullivan Jr, MD 1501 Kings Hwy, Shreveport, LA 71103-4228 Ph: (318) 675-5000

Reviews and Comments

Pediatrics Doctors in Shreveport, LA

Shaheena Anene, Pediatrics Medicare: Medicare Enrolled Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000
Uday Kumar Chalwadi, Pediatrics Medicare: Medicare Enrolled Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000
Lea Bonifacio Penales, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2520 Bert Kouns Loop, Suite 215, Shreveport, LA 71118 Phone: 318-212-5970 Fax: 318-212-5975
Marco Quispe Leveau, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1501 Kings Hwy, Department Of Medicine, Shreveport, LA 71103 Phone: 318-675-5000
Amanda Bradshaw Raney, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 7045 Youree Dr, Shreveport, LA 71105 Phone: 318-798-3763 Fax: 318-797-0645
Martha M Whyte, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1 Saint Mary Pl, Shreveport, LA 71101 Phone: 318-227-4658 Fax: 318-424-6606
Dr. Stephanie Boyd Henson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1801 Fairfield Ave, Suite 201, Shreveport, LA 71101 Phone: 318-848-2810 Fax: 318-848-2815

Dr Fred M Sullivan Jr, MD - Medicare Pediatrics in Shreveport, LA