DR. JOHN MAGRUDER SULLIVAN III MD
NPI 1043872948
Surgery - Plastic and Reconstructive Surgery in Jackson, MS

NPI Status: Active since July 01, 2019

Contact Information

2500 N STATE ST
JACKSON, MS
ZIP 39216
Phone: (601) 984-1000

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  • Individual
  • Male
  • Years of Experience 1
  • Surgery
  • Plastic and Reconstructive Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JOHN SULLIVAN

This page provides the complete NPI Profile along with additional information for John Sullivan, a provider established in Jackson, Mississippi with a medical specialization in Surgery, focusing in plastic and reconstructive surgery and more than one year of experience. He graduated from University Of Mississippi School Of Medicine in 2025. The healthcare provider is registered in the NPI registry with number 1043872948 assigned on July 2019. The practitioner's primary taxonomy code is 2086S0122X with license number T-3879 (MS). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1043872948
Provider Name
DR. JOHN MAGRUDER SULLIVAN III MD
Gender
Male
Entity Type
Individual
Location Address
2500 N STATE ST JACKSON, MS 39216
Location Phone
(601) 984-1000
Mailing Address
37 ENCLAVE CIR RIDGELAND, MS 39157
Mailing Phone
(601) 953-3304
Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduation Year
2025
Is Sole Proprietor?
No
Enumeration Date
07-01-2019
Last Update Date
07-01-2019
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Surgery Plastic and Reconstructive Surgery

Taxonomy Code
2086S0122X
Type
Allopathic & Osteopathic Physicians
License No.
T-3879
License State
MS
Taxonomy Description
A surgeon who specializes in plastic and reconstructive surgery.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Blue HSA Bronze - PPO
  • Blue Protect - PPO
  • Blue Saver Bronze - PPO
  • Blue Standardized Statewide Silver EPO - EPO
  • Blue Statewide Silver EPO - EPO
  • Blue Value Gold - PPO
  • Blue Value Silver - PPO
  • Blue Access Gold for Business - PPO
  • Blue Choice Platinum for Business - PPO
  • Blue HSA Silver for Business - PPO
  • Molina Gold Standard - HMO
  • Molina Silver Standard - HMO
  • Bronze Classic Standard - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Gold Classic Standard - HMO
  • Silver Classic Standard - HMO
  • Silver Simple - HMO
  • Silver Simple Chronic Care CKM - HMO

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

Medicare Participation & PECOS Enrollment Status

John Sullivan is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

John 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 5698284578

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20250602003624

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Reviews for DR. JOHN MAGRUDER SULLIVAN III MD

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1043872948, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
7
Unchanged
Pos 7
2
Doubled → 4
Pos 8
9
Unchanged
Pos 9
4
Doubled → 8
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 8 → 16 → 7 2 → 4 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 8 + 3 + 1 + 6 + 7 + 4 + 9 + 8 + 24 = 72

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1043872948.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Ophthalmology
2500 N STATE ST, STE B329
JACKSON, MS 39216
Pharmacist (Psychiatric)
2500 N STATE ST
JACKSON, MS 39216
Rehabilitation Unit
2500 N STATE ST
JACKSON, MS 39216
Otolaryngology
2500 N STATE ST, DEPARTMENT OF OTOLARYNGOLOGY
JACKSON, MS 39216
Dentist
2500 N STATE ST
JACKSON, MS 39216
Anesthesiology (Pediatric Anesthesiology)
2500 N STATE ST, DEPT. OF ANESTHESIOLOGY
JACKSON, MS 39216
Dentist
2500 N STATE ST, UNIVERSITY OF MISSISSIPPI SCHOOL OF DENTISTRY
JACKSON, MS 39216
Physical Medicine & Rehabilitation (Pediatric Rehabilitation Medicine)
2500 N STATE ST
JACKSON, MS 39216
Psychologist (Clinical)
2500 N STATE ST
JACKSON, MS 39216
Nurse Practitioner
2500 N STATE ST
JACKSON, MS 39216
Neurological Surgery
2500 N STATE ST, N703 NEUROSURGERY DEPARTMENT
JACKSON, MS 39216
Psychiatry & Neurology (Psychiatry)
2500 N STATE ST
JACKSON, MS 39216
Clinical Neuropsychologist
2500 N STATE ST
JACKSON, MS 39216
Psychologist (Clinical)
2500 N STATE ST
JACKSON, MS 39216
Medical Genetics (Clinical Genetics (M.D.))
2500 N STATE ST, DEPARTMENT OF PREVENTIVE MEDICINE
JACKSON, MS 39216
Clinical Medical Laboratory
2500 N STATE ST
JACKSON, MS 39216
Pediatrics (Pediatric Critical Care Medicine)
2500 N STATE ST
JACKSON, MS 39216
Pediatrics (Pediatric Critical Care Medicine)
2500 N STATE ST
JACKSON, MS 39216
Pediatrics (Pediatric Infectious Diseases)
2500 N STATE ST
JACKSON, MS 39216
Pediatrics
2500 N STATE ST
JACKSON, MS 39216

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043872948, enumerated as an "individual" on July 01, 2019.

The provider is located at 2500 N STATE ST JACKSON, MS 39216 and the phone number is (601) 984-1000.

Surgery with taxonomy code 2086S0122X and a focus in Plastic and Reconstructive Surgery.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.