Michael Patrick Sullivan, MD is a medicare enrolled "Psychiatry & Neurology - Neurology" physician in So Lake Tahoe, California. His current practice location is
2101 South Ave, So Lake Tahoe, California. You can reach out to his office (for appointments etc.) via phone at
(530) 542-5744.
Michael Patrick Sullivan is licensed to practice in California (license number G40941) 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 1336105626.
Physician's Profile
| Full Name | Michael Patrick Sullivan |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 2101 South Ave, So Lake Tahoe, California |
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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:
- Michael Patrick Sullivan attended and graduated from in
NPI Data:
- NPI Number: 1336105626
- Provider Enumeration Date: 04/25/2006
- Last Update Date: 09/28/2012
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Michael Patrick Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1336105626 | NPI | - | NPPES |
| 00G409410 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | G40941 (California) | Primary |
| 2084N0400X | Psychiatry & Neurology - Neurology | 6833 (Nevada) | Secondary |
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 Patrick 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 Patrick Sullivan, MD
2101 South Ave,
So Lake Tahoe, CA 96150
Ph: (530) 542-5744 | Michael Patrick Sullivan, MD
2101 South Ave,
So Lake Tahoe, CA 96150
Ph: (530) 542-5744 |
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