NPI Details
Sabra Sullivan, M.D., PHD. is a procedural dermatology dermatology in Jackson, MS with 38 years of experience. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). Sabra Sullivan, M.D., PHD. NPI is 1932176641. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
Education
Medical School: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduation Year:1988
The provider's business location address is:
501 MARSHALL ST
SUITE 606
JACKSON, MS
ZIP 39202-651
Phone: (601) 355-8555
Fax: (601) 355-2244
The NPI 1932176641 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.
- Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
- Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
- Destruction of precancer skin growth, 1 growth (HCPCS:17000)
- Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
- Punch biopsy, first skin growth (HCPCS:11104)
- Punch biopsy, each additional skin growth (HCPCS:11105)
- Destruction of precancer skin growth, 15 or more growths (HCPCS:17004)
- Biopsy of related skin growth, first growth (HCPCS:11102)
- Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
- Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks (HCPCS:17311)
- Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm (HCPCS:12032)
- Destruction of skin growth, 1-14 growths (HCPCS:17110)
- Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm (HCPCS:12052)
- Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11602)
- Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
- Injection into skin growth, 1-7 growths (HCPCS:11900)
- Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm (HCPCS:11603)
- Melanoma (skin cancer) excision (HCPCS:NAN03)
The enumeration date for this NPI number is 3/1/2006 and was last updated on 6/14/2010.
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 |
| 1 | 207NS0135X | Dermatology | Procedural Dermatology | 14238 | MISSISSIPPI | Yes |
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 |
| 1 | 070000095 | MEDICARE ID-TYPE UNSPECIFIED | MISSISSIPPI | |
| 2 | F28566 | MEDICARE UPIN | MISSISSIPPI | |
| 3 | 0114928 | MEDICAID | MISSISSIPPI | |
