DR. PATSA H SULLIVAN M.D. NPI 1013093061
Radiology - Radiation Oncology in Minneapolis, MN

About DR. PATSA H SULLIVAN M.D.

Patsa Sullivan is a provider established in Minneapolis, Minnesota and her medical specialization is Radiology with a focus in radiation oncology with more than 23 years of experience. She graduated from Washington University School Of Medicine in 2000. The NPI number of Patsa Sullivan is 1013093061 and was assigned on October 2006. The practitioner's primary taxonomy code is 2085R0001X with license number 47577 (MN). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1013093061
Provider NameDR. PATSA H SULLIVAN M.D.
Location Address800 E 28TH STREET MINNEAPOLIS, MN 55407
Location Phone(612) 863-4060
Mailing Address800 E 28TH STREET MINNEAPOLIS, MN 55407
GenderFemale
NPI Entity TypeIndividual
Medical School NameWASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year2000
Is Sole Proprietor?No
Enumeration Date10-31-2006
Last Update Date11-10-2020

Patsa Sullivan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Patsa Sullivan is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with Abbott Northwestern Hospital and Allina United Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 91.5, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $43.71 for a new patient copayment and $18.15 for an established patient copayment.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code2085R0001X
ClassificationRadiology
TypeAllopathic & Osteopathic Physicians
SpecializationRadiation Oncology
License No.47577
License StateMN
Taxonomy DescriptionA radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

DR. PATSA H SULLIVAN M.D.
800 E 28TH STREET
MINNEAPOLIS, MN
ZIP 55407
Phone: (612) 863-4060
Fax: (952) 808-8131

Get Directions


Mailing Address

DR. PATSA H SULLIVAN M.D.
800 E 28TH STREET
MINNEAPOLIS, MN
ZIP 55407
Phone: (612) 863-4060
Fax: (612) 863-4963


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID6204862527
PECOS Enrollment IDI20050708000690
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 55407 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99205
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$57.95 $174.84 $174.84
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.48 $43.71 $43.71
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$18.41 $143.56 $72.62
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.6 $35.89 $18.15

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 98.8
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 76
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% 72.8
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 91.5
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 157Radiation treatment devices, design and construction, complex (HCPCS:77334)
  • 149Calculation of radiation therapy dose (HCPCS:77300)
  • 86Radiation treatment management, 5 treatments (HCPCS:77427)
  • 37Management of radiation therapy, complex (HCPCS:77263)
  • 35Management of radiation therapy, simulation, complex (HCPCS:77290)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Patsa Sullivan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ABBOTT NORTHWESTERN HOSPITAL800 EAST 28TH STREET
MINNEAPOLIS, MN 55407
(612) 863-4457Acute Care Hospitals240057
ALLINA UNITED HOSPITAL333 NORTH SMITH AVENUE
SAINT PAUL, MN 55102
(651) 241-8810Acute Care Hospitals240038

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
724486000MEDICAID (05)MN

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1013093061
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023096012
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 9 + 6 + 0 + 1 + 2 + 24 = 49
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 49 = 11

The NPI number 1013093061 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1558338335 REBECCA R KUEHN MD
Individual
Anesthesiology800 E 28TH STREET
MINNEAPOLIS, MN 55407
(612) 871-7639
1922060177 TIMOTHY D SIELAFF MD PHD
Individual
Surgery800 E 28TH STREET MAIL ROUTE 39602
MINNEAPOLIS, MN 55407
(612) 863-4633
1841436250MS. PAIGE RENEE SAFRANSKI CTRS
Individual
Recreation Therapist800 E 28TH STREET MAIL ROUTE 12213
MINNEAPOLIS, MN 55407
(612) 863-5712
1033590088DR. NATHAN DEAN SWENSON M.D.
Individual
Emergency Medicine800 E 28TH STREET
MINNEAPOLIS, MN 55407
(612) 863-6266
1295111300 PATRICIA ANN BERNAL NNP-BC
Individual
Nurse Practitioner800 E 28TH STREET
MINNEAPOLIS, MN 55407
(612) 863-4000

Frequently Asked Questions

What is Dr. Patsa Sullivan M.D. NPI number?

The NPI number assigned to Dr. Patsa Sullivan M.D. is 1013093061, registered as an "individual" on October 31, 2006

Where is Dr. Patsa Sullivan M.D. located?

The provider is located at 800 E 28th Street Minneapolis, Mn 55407 and the phone number is (612) 863-4060

Which is Dr. Patsa Sullivan M.D. specialty?

The provider's speciality is Radiology with a focus in Radiation Oncology

How many years of experience does Dr. Patsa Sullivan M.D. have?

The provider has more than 23 years of experience. She graduated from Washington University School Of Medicine in 2000.

What insurance does Dr. Patsa Sullivan M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. Patsa Sullivan M.D. registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

How much is a visit to Dr. Patsa Sullivan M.D.?

Medicare beneficiaries should expect a typical cost of $174.84 with an average copayment of $43.71 for new patient appointments. Established patients should expect a typical charge of $72.62 and an average copayment of 18.15. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Patsa Sullivan M.D.?

The most common procedures or services performed by this practitioner are: Radiation treatment devices, design and construction, complex, Calculation of radiation therapy dose, Radiation treatment management, 5 treatments, Management of radiation therapy, complex and Management of radiation therapy, simulation, complex.

Is Dr. Patsa Sullivan M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: ABBOTT NORTHWESTERN HOSPITAL and ALLINA UNITED HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

The NPI record of Dr. Patsa Sullivan M.D. was last updated on October 31, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]