Tim Sullivan, MD in Sonora, CA - Medicare Pediatrics

Tim Sullivan, MD is a medicare enrolled "Pediatrics" physician in Sonora, California. His current practice location is 12791 Cabezut Rd, Sonora, California. You can reach out to his office (for appointments etc.) via phone at (209) 532-5524.

Tim Sullivan is licensed to practice in California (license number C55917) 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 1750481099.

Contact Information

	Tim Sullivan, MD
	12791 Cabezut Rd, Sonora, CA 95370-5926
	(209) 532-5524
	(209) 532-1513

Map and Direction

Physician's Profile

Full Name	Tim Sullivan
Gender	Male
Speciality	Pediatrics
Location	12791 Cabezut Rd, Sonora, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750481099
Provider Enumeration Date: 09/25/2006
Last Update Date: 07/29/2019

Medicare PECOS Information:

PECOS PAC ID: 6901045517
Enrollment ID: I20130717000719

Medical Identifiers

Medical identifiers for Tim Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750481099	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	34411 (Iowa)	Secondary
208000000X	Pediatrics	C55917 (California)	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. Tim Sullivan allows following entities to bill medicare on his behalf.

Entity Name	Sonora Community Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891732418 PECOS PAC ID: 4284538505 Enrollment ID: O20031119000910

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. Tim 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
Tim Sullivan, MD 12791 Cabezut Rd, Sonora, CA 95370-5926 Ph: (209) 532-5524	Tim Sullivan, MD 12791 Cabezut Rd, Sonora, CA 95370-5926 Ph: (209) 532-5524

Reviews and Comments

Pediatrics Doctors in Sonora, CA

Dr. William H. Birtwhistle, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 12791 Cabezut Rd, Sonora, CA 95370 Phone: 209-532-5524 Fax: 209-532-1518
William Donovan Spangler, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 12971 Cabezut Rd, Sonora, CA 95370 Phone: 209-532-5524 Fax: 209-532-1513
Dr. Kelley William George, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 12791 Cabezut Rd, Sonora, CA 95370 Phone: 209-532-5524
Andrew James Terranella, MD, MPH Pediatrics Medicare: Medicare Enrolled Practice Location: 20963 Spanish Grant Dr, Sonora, CA 95370 Phone: 989-528-0795
Dr. Jennifer Lynn Neufeld-trujillo, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 193 South Fairview Lane, Ste L, Sonora, CA 95370 Phone: 209-536-5120

Tim Sullivan, MD - Medicare Pediatrics in Sonora, CA