Scott Sullivan, in Lake Wylie, SC - Medicare Physical Therapist Provider

Scott Sullivan, is a medicare enrolled "Physical Therapist" provider in Lake Wylie, South Carolina. His current practice location is 439 Channel Rd Ste 102, Lake Wylie, South Carolina. You can reach out to his office (for appointments etc.) via phone at (803) 746-7800.

Scott Sullivan is licensed to practice in South Carolina (license number 12553) 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 1477070522.

Contact Information

	Scott Sullivan,
	439 Channel Rd Ste 102, Lake Wylie, SC 29710-6101
	(803) 746-7800
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Scott Sullivan
Gender	Male
Speciality	Physical Therapist
Location	439 Channel Rd Ste 102, Lake Wylie, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1477070522
Provider Enumeration Date: 08/29/2017
Last Update Date: 02/07/2025

Medicare PECOS Information:

PECOS PAC ID: 4688114739
Enrollment ID: I20240904003084

Medical Identifiers

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

Identifier	Type	State	Issuer
1477070522	NPI	-	NPPES
20579	Other	NC	PROFESSIONAL LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	20579 (North Carolina)	Secondary
2251X0800X	Physical Therapist - Orthopedic	PTL.0015126 (Colorado)	Secondary
225100000X	Physical Therapist	12553 (South Carolina)	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. Scott Sullivan allows following entities to bill medicare on his behalf.

Provider Name	Ivyrehab Focus, Inc.
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1518105279 PECOS PAC ID: 5890851406 Enrollment ID: O20090306000118

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. Scott 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
Scott Sullivan, Po Box 412066, Boston, MA 02241-2066 Ph: (914) 294-4050	Scott Sullivan, 439 Channel Rd Ste 102, Lake Wylie, SC 29710-6101 Ph: (803) 746-7800

Reviews and Comments

Physical Therapist in Lake Wylie, SC

Dr. Thomas Calvin Mealing, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 439 Channel Rd Ste 102, Lake Wylie, SC 29710 Phone: 803-746-7800 Fax: 803-746-7807
Hannah Louise Saxe, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 439 Channel Rd Ste 102, Lake Wylie, SC 29710 Phone: 803-746-7800
Carley Schron, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 439 Channel Rd Ste 102, Lake Wylie, SC 29710 Phone: 803-746-7800
Richard F Biggers, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 439 Channel Rd, Suite 102, Lake Wylie, SC 29710 Phone: 803-746-7800 Fax: 803-746-7807
Adam Riddle, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 439 Channel Rd Ste 102, Lake Wylie, SC 29710 Phone: 803-746-7800 Fax: 803-746-7807
Susan Dinlocker, Physical Therapist Medicare: Medicare Enrolled Practice Location: 716 Kingsmill Ln, Lake Wylie, SC 29710 Phone: 866-571-2700
Ms. Michelle Marie Semidey, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4543 Charlotte Hwy Ste 11, Lake Wylie, SC 29710 Phone: 803-831-1454

Scott Sullivan, - Medicare Physical Therapist in Lake Wylie, SC