Kelly Elizabeth Sullivan, AGNP-C in Vernon, CT

Kelly Elizabeth Sullivan, AGNP-C is a medicare enrolled "Nurse Practitioner - Primary Care" in Vernon, Connecticut. Her current practice location is 428 Hartford Tpke Ste 207, Vernon, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 872-5426.

Kelly Elizabeth Sullivan is licensed to practice in Connecticut (license number 390200000X) 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 1427549088.

Contact Information

	Kelly Elizabeth Sullivan, AGNP-C
	428 Hartford Tpke Ste 207, Vernon, CT 06066-4841
	(860) 872-5426
	Not Available

Map and Direction

Provider's Profile

Full Name	Kelly Elizabeth Sullivan
Gender	Female
Speciality	Nurse Practitioner - Primary Care
Location	428 Hartford Tpke Ste 207, Vernon, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427549088
Provider Enumeration Date: 05/19/2018
Last Update Date: 05/19/2018

Medicare PECOS Information:

PECOS PAC ID: 8123376803
Enrollment ID: I20180813002528

Medical Identifiers

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

Identifier	Type	State	Issuer
1427549088	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP2300X	Nurse Practitioner - Primary Care	390200000X (Connecticut)	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. Kelly Elizabeth Sullivan allows following entities to bill medicare on her behalf.

Entity Name	Intercommunity Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073548533 PECOS PAC ID: 9032001649 Enrollment ID: O20040329000218

Entity Name	Connecticut Gi Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023124625 PECOS PAC ID: 9830110758 Enrollment ID: O20070112000011

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. Kelly Elizabeth 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
Kelly Elizabeth Sullivan, AGNP-C 428 Hartford Tpke Ste 207, Vernon, CT 06066-4841 Ph: () -	Kelly Elizabeth Sullivan, AGNP-C 428 Hartford Tpke Ste 207, Vernon, CT 06066-4841 Ph: (860) 872-5426

Reviews and Comments

Nurse Practitioner Nurses in Vernon, CT

Jude Hall, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 30 Hyde Ave Ste 109, Vernon, CT 06066 Phone: 860-454-0303 Fax: 860-875-4242
Kellie Angela Ford, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 35 Talcottville Road, Suite 6, Vernon, CT 06066 Phone: 860-870-6385 Fax: 860-870-0625
Lauren Speringo, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 281 Hartford Tpke, Vernon, CT 06066 Phone: 860-970-6264
Erin Perry, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 179 Talcottville Rd, Vernon, CT 06066 Phone: 860-986-7600
Ms. Irina Bratan, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 35 Talcottvile Road, Vernon, CT 06066 Phone: 860-787-5774
Jennifer Maria Sousa Jerome, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 281 Hartford Tpke Ste 106, Vernon, CT 06066 Phone: 860-375-2227 Fax: 860-603-5080
Mrs. Amy Lynn Lombardo, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 30 Hyde Ave Ste 109, Vernon, CT 06066 Phone: 860-454-0303 Fax: 860-875-4242

Kelly Elizabeth Sullivan, AGNP-C - Medicare Nurse Practitioner in Vernon, CT