Katelyn Sullivan, is a medicare enrolled "Physical Medicine & Rehabilitation" provider in Brooklyn, New York. Her current practice location is
594 Albany Ave, Brooklyn, New York. You can reach out to her office (for appointments etc.) via phone at
(718) 245-7000.
Katelyn Sullivan is licensed to practice in Indiana (license number 05011954A.) 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 1578048690.
Healthcare Provider's Profile
| Full Name | Katelyn Sullivan |
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| Gender | Female |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 594 Albany Ave, Brooklyn, New York |
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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: 1578048690
- Provider Enumeration Date: 09/25/2018
- Last Update Date: 01/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 9739531492
- Enrollment ID: I20240118000313
Medical Identifiers
Medical identifiers for Katelyn Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578048690 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | 15410 (Tennessee) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 05011954A. (Indiana) | 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. Katelyn Sullivan allows following entities to bill medicare on her behalf.
| Provider Name | Results-ast Jv Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1780291948
PECOS PAC ID: 4486066396
Enrollment ID: O20201217003061 |
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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. Katelyn 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 |
|---|
Katelyn Sullivan,
1200 Corporate Dr Ste 400,
Hoover, AL 35242-5424
Ph: (423) 238-7217 | Katelyn Sullivan,
594 Albany Ave,
Brooklyn, NY 11203-1706
Ph: (718) 245-7000 |
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