Dr Mari Catherine Sullivan, DNP, MSN, ARNP-C is a medicare enrolled "Family Medicine" in Kingston, Washington. Her current practice location is
Port Gamble S'klallam Tribe Community Health, 32020 Little Boston Rd Ne, Kingston, Washington. You can reach out to her office (for appointments etc.) via phone at
(360) 297-2840.
Dr Mari Catherine Sullivan is licensed to practice in Washington (license number AP30001946) 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 1750449344.
Provider's Profile
| Full Name | Dr Mari Catherine Sullivan |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | Port Gamble S'klallam Tribe Community Health, Kingston, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1750449344
- Provider Enumeration Date: 12/05/2006
- Last Update Date: 08/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 2668826314
- Enrollment ID: I20230928002004
Medical Identifiers
Medical identifiers for Dr Mari Catherine Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1750449344 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | AP300001946 (Washington) | Secondary |
| 207Q00000X | Family Medicine | AP30001946 (Washington) | 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 Mari Catherine Sullivan allows following entities to bill medicare on her behalf.
| Entity Name | Port Gamble S'klallam Tribe |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760428650
PECOS PAC ID: 6204737927
Enrollment ID: O20040115001158 |
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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. Dr Mari Catherine 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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Dr Mari Catherine Sullivan, DNP, MSN, ARNP-C
32020 Little Boston Rd Ne,
Kingston, WA 98346-9734
Ph: (360) 297-2840 | Dr Mari Catherine Sullivan, DNP, MSN, ARNP-C
Port Gamble S'klallam Tribe Community Health, 32020 Little Boston Rd Ne,
Kingston, WA 98346
Ph: (360) 297-2840 |
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