DR. MATTHEW RYAN SULLIVAN OD NPI 1053311472

NPI Information

  • NPI: 1053311472
  • Provider Name: DR. MATTHEW RYAN SULLIVAN, OD
  • Classification: Optometrist - 152W00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 980 WILLOW CREEK ROAD
    SUITE 202
    PRESCOTT, AZ
    ZIP 86301
  • Phone: (928) 778-3937

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NPI Details

DR. Matthew Ryan Sullivan, OD is an optometrist in Prescott, AZ with 26 years of experience. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. DR. Matthew Ryan Sullivan, OD NPI is 1053311472. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY
Graduation Year:2000

The provider's business location address is:

980 WILLOW CREEK ROAD
SUITE 202
PRESCOTT, AZ
ZIP 86301-610
Phone: (928) 778-3937
Fax: (928) 778-3939

The NPI 1053311472 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Photography of the retina (HCPCS:92250)
  • Established patient complete exam of visual system (HCPCS:92014)
  • Exam of visual field with intermediate testing (HCPCS:92082)
  • Established patient problem focused exam of visual system (HCPCS:92012)
  • Closure of tear duct opening using plug (HCPCS:68761)
  • Exam of visual field with extended testing (HCPCS:92083)
  • Exam of the internal drainage system of eye (HCPCS:92020)
  • Imaging of optic nerve (HCPCS:92133)
  • Evaluation of eye adaptation to light and dark (HCPCS:92284)
  • Imaging of retina (HCPCS:92134)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Extended exam of the back part of the eye with optic nerve drawing (HCPCS:92202)
  • Extended exam of the back part of the eye with retinal drawing (HCPCS:92201)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Removal of cataract with insertion of prosthetic lens (HCPCS:66984)
  • Ultrasound scan to determine eye length and lens power (HCPCS:76519)
  • Ultrasound scan of cornea to determine thickness (HCPCS:76514)
  • Dilation of tear drainage opening (HCPCS:68801)
  • Photography of content of eyes (HCPCS:92285)
  • Removal of recurring cataract in lens capsule using a laser (HCPCS:66821)
  • New patient complete exam of visual system (HCPCS:92004)

The enumeration date for this NPI number is 7/28/2005 and was last updated on 1/2/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometrist1102ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11053311472OTHERARIZONAINDIVIDUAL NPI
21102OTHERARIZONASTATE LICENSE
31285813360OTHERARIZONAGROUP NPI
4U82033MEDICARE UPINARIZONA
5620353MEDICAIDARIZONA
664295MEDICARE PINARIZONA
7410045761OTHERARIZONARAILROAD
864294OTHERARIZONAMEDICARE GROUP NUMBER
9Z64295MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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