Mitchell Sullivan, MD is a medicare enrolled "Family Medicine" physician in Lyndonville, Vermont. He graduated from medical school in 1992 and has 32 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Northeastern Vermont Regional Hospital Inc and his current practice location is
195 Industrial Pkwy, Lyndonville, Vermont. You can reach out to his office (for appointments etc.) via phone at
(802) 748-9501.
Mitchell Sullivan is licensed to practice in Vermont (license number 042-0012982) 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 1841292562.
Physician's Profile
| Full Name | Mitchell Sullivan |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 32 Years |
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| Location | 195 Industrial Pkwy, Lyndonville, Vermont |
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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:
- Mitchell Sullivan graduated from medical school in 1992
NPI Data:
- NPI Number: 1841292562
- Provider Enumeration Date: 08/12/2005
- Last Update Date: 03/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 8022024108
- Enrollment ID: I20141121000566
Medical Identifiers
Medical identifiers for Mitchell Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841292562 | NPI | - | NPPES |
| 160094 | Other | NH | CIGNA HEALTHCARE |
| 0106084YPNH01 | Other | NH | ANTHEM BC/BS |
| 5830418 | Other | | AETNA GROUP |
| 9367 | Other | NH | STATE LICENSE # |
| 30008999 | Medicaid | NH | |
| 930044719 | Other | | RAILROAD MEDICARE |
| 3073723 | Medicaid | NH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 9367 (New Hampshire) | Secondary |
| 207Q00000X | Family Medicine | 042-0012982 (Vermont) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Northeastern Vermont Regional Hospital Inc | 3678481405 | 103 |
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. Mitchell Sullivan allows following entities to bill medicare on his behalf.
| Entity Name | Northeastern Vermont Regional Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659459428
PECOS PAC ID: 3678481405
Enrollment ID: O20080208000261 |
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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. Mitchell 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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Mitchell Sullivan, MD
Po Box 83,
Lyndonville, VT 05851-0083
Ph: (802) 748-9501 | Mitchell Sullivan, MD
195 Industrial Pkwy,
Lyndonville, VT 05851-4511
Ph: (802) 748-9501 |
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