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KELLEN A. SULLIVAN MD
NPI 1003479270
Internal Medicine in Salt Lake City, UT

Active since April 15, 2019PECOS EnrolledAccepts Medicare Assignment
88.67/100
CMS Quality Rating
30 N 1900 E RM 4C116, SALT LAKE CITY, UT 84132(801) 581-7606 Get Directions Write a Review

NPPES record last updated: August 24, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 24, 2020, Apr 15, 2019 (2 updates tracked since 2019).

About Kellen A. Sullivan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLEN A. SULLIVAN MD (NPI 1003479270) is an individual internal medicine provider in Salt Lake City, Utah, licensed in Utah (11898972-1205) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with Legacy Salmon Creek Medical Center, and is a graduate of Ohio State University College Of Medicine (2019).

NPPES Registry Identity

NPI1003479270
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameKELLEN A. SULLIVANCredential: MD
Location Address30 N 1900 E RM 4C116Salt Lake City, UT 84132-0002
Mailing Address30 N 1900 E Rm 4c116Salt Lake City, UT 84132-0002 · (801) 581-7606
Phone(801) 581-7606
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2019
Enumeration DateApril 15, 2019
Last NPPES UpdateAugust 24, 20202 updates tracked since enumeration
NPPES CertifiedAugust 24, 2020
✔ NPI 1003479270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in UT · 11898972-1205
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
30 N 1900 E RM 4C116, Salt Lake City, UT 84132
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kellen A. Sullivan Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991123556
PECOS Enrollment IDI20220622002957
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
87 services40 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
78 services74 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
36 services19 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
27 services25 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Legacy Salmon Creek Medical Center

Acute Care Hospitals · Vancouver, WA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500150
Location2211 NE 139th StreetVancouver, WA 98686 · Clark County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84132 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

88.67/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.54
Promoting Interoperability100
Improvement Activities40
Cost70.7

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SIDDHARTH K. IYENGAR MD
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7606
DAVID C. HAAK MD
Hospitalist
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-3580
DR. CHARLES W. CUBBERLEY MD
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-3580
ALICIA HSU BOWLES MD
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7606
ANEES DAUD
Internal Medicine (Cardiovascular Disease)
30 N 1900 E RM 4C116, UNIVERSITY OF UTAH DEPARTMENT OF MEDICINE OFFICE OF EDU
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-0418
JAWAD S A ALMAJED MBBS
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-3580
ELENA G. GIBSON MD
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7606
GUINN ELLEN DUNN MD
Hospitalist
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7606

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kellen Sullivan's NPI number?

The NPI number for Kellen Sullivan is 1003479270. It was assigned to this individual provider in the NPPES registry on April 15, 2019.

Where is Kellen Sullivan located?

Kellen Sullivan practices at 30 N 1900 E Rm 4c116, Salt Lake City, UT 84132. The listed phone number is (801) 581-7606.

What is Kellen Sullivan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kellen Sullivan enrolled in Medicare?

Yes. Kellen Sullivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Kellen Sullivan affiliated with any hospitals?

According to CMS data, Kellen Sullivan is affiliated with Legacy Salmon Creek Medical Center.

When was this NPI record last updated?

The NPPES record for Kellen Sullivan was last updated on August 24, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.