MICHAEL E SULLIVAN M.D. NPI 1093883142

NPI Information

  • NPI: 1093883142
  • Provider Name: MICHAEL E SULLIVAN, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 127 HOSPITAL DR
    WATERTOWN, WI
    ZIP 53098
  • Phone: (920) 261-8500

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NPI Details

Michael E Sullivan, M.D. is a family medicine in Watertown, WI with 25 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Michael E Sullivan, M.D. NPI is 1093883142. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year:2001

The provider's business location address is:

127 HOSPITAL DR
WATERTOWN, WI
ZIP 53098-303
Phone: (920) 261-8500

The NPI 1093883142 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), Power Mobility Devices.

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.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Follow-up nursing facility visit per day, typically 15 minutes (HCPCS:99308)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Blood test, clotting time (HCPCS:85610)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Anticoagulant management of patient taking warfarin (HCPCS:93793)
  • Initial nursing facility visit per day, typically 45 minutes (HCPCS:99306)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
  • Destruction of precancer skin growth, 1 growth (HCPCS:17000)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Follow-up nursing facility visit per day, typically 10 minutes (HCPCS:99307)
  • Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit (HCPCS:G0438)
  • Initial nursing facility visit per day, typically 35 minutes (HCPCS:99305)
  • Removal of impacted ear wax (HCPCS:69210)
  • Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) (HCPCS:G0296)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Urinalysis, manual test (HCPCS:81002)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Adm sarscov2 100mcg/0.5ml3rd (HCPCS:0013A)
  • Transitional care management services for problem of moderate complexity (HCPCS:99495)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 11/30/2006 and was last updated on 4/7/2022.

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
1207Q00000XFamily Medicine46656WISCONSINYes

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
134560600MEDICAIDWISCONSIN

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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