Dr Lisa C Sullivan, MD - Medicare Pediatrics in Milwaukie, OR

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Dr Lisa C Sullivan, MD is a medicare enrolled "Pediatrics" physician in Milwaukie, Oregon. Her current practice location is 4950 Se Roethe Rd, Milwaukie, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 722-6858.

Dr Lisa C Sullivan is licensed to practice in Oregon (license number MD24619) 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 1841380375.

Contact Information

Dr Lisa C Sullivan, MD
4950 Se Roethe Rd,
Milwaukie, OR 97267-5746
(503) 722-6858
(503) 722-6826

Map and Direction




Physician's Profile

Full NameDr Lisa C Sullivan
GenderFemale
SpecialityPediatrics
Location4950 Se Roethe Rd, Milwaukie, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1841380375
  • Provider Enumeration Date: 10/13/2006
  • Last Update Date: 06/27/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 1658463245
  • Enrollment ID: I20070828000310

Medical Identifiers

Medical identifiers for Dr Lisa C Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1841380375NPI-NPPES
096511MedicaidOR
240558MedicaidOR
22959MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics MD24619 (Oregon)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. Dr Lisa C Sullivan allows following entities to bill medicare on her behalf.
Entity NameMultnomah County
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609914787
PECOS PAC ID: 6608771787
Enrollment ID: O20031203000025
Entity NameCounty of Clackamas Office of County Auditor
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841443587
PECOS PAC ID: 9537065560
Enrollment ID: O20031210000827

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 Lisa C 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 AddressPractice Location Address
Dr Lisa C Sullivan, MD
421 Sw Oak St, Ste 210,
Portland, OR 97204-1817

Ph: (503) 988-7468		Dr Lisa C Sullivan, MD
4950 Se Roethe Rd,
Milwaukie, OR 97267-5746

Ph: (503) 722-6858

Reviews and Comments


Pediatrics Doctors in Milwaukie, OR

Donald W. Fortlage,
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 10202 Se 32nd Ave, Suite 201, Milwaukie, OR 97222
Phone: 503-653-0770    Fax: 503-653-0844

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.