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DR. JEREMY TYSON SULLIVAN M.D.
NPI 1053379644
Internal Medicine in Carmel, IN

Active since May 03, 2006PECOS Enrolled
10601 WINTERWOOD, CARMEL, IN 46032(615) 478-3720 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Jeremy Tyson Sullivan M.d. NPPES

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

DR. JEREMY TYSON SULLIVAN M.D. (NPI 1053379644) is an individual internal medicine provider in Carmel, Indiana, licensed in Indiana (01066525A) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053379644
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JEREMY TYSON SULLIVANCredential: M.D.
Location Address10601 WINTERWOODCarmel, IN 46032-8258
Mailing Address10601 WinterwoodCarmel, IN 46032-8258 · (615) 478-3720
Phone(615) 478-3720
Sole ProprietorYes
Enumeration DateMay 3, 2006
Last NPPES UpdateMarch 7, 2023
✔ NPI 1053379644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IN · 01066525A
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.
Also ListedSpecialistTaxonomy 174400000X · License 35131 (TN)
10601 WINTERWOOD, Carmel, IN 46032
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Other Identifiers 1

Medicaid3865060TN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jeremy Tyson Sullivan M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

3

Medicare enrollment records show Jeremy Sullivan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

My Mobile MD LLC
12 mi
Family Medicine
429 E VERMONT ST STE 110
Indianapolis, IN 46202
  • Reassigned Medicare billing, Indiana enrollment
  • 45 clinicians in this Medicare group
NPI 1225495716 (317) 559-0950
Assurance Health Indianapolis, LLC
13 mi
Psychiatric Hospital
900 N HIGH SCHOOL RD
Indianapolis, IN 46214
  • Reassigned Medicare billing, Indiana enrollment
  • 7 clinicians in this Medicare group
NPI 1811347651 (317) 982-3715
Psychiatric Management Services
25 mi
Psychiatry
2725 ENTERPRISE DR
Anderson, IN 46013
  • Reassigned Medicare billing, Indiana enrollment
  • 11 clinicians in this Medicare group
NPI 1942677281 (317) 870-1553

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46032 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

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 Jeremy Sullivan's NPI number?

The NPI number for Jeremy Sullivan is 1053379644. It was assigned to this individual provider in the NPPES registry on May 3, 2006.

Where is Jeremy Sullivan located?

Jeremy Sullivan practices at 10601 Winterwood, Carmel, IN 46032. The listed phone number is (615) 478-3720.

What is Jeremy Sullivan's specialty?

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

Is Jeremy Sullivan enrolled in Medicare?

Yes. Jeremy Sullivan is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jeremy Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeremy Sullivan reassigns Medicare benefits to 3 organizations: My Mobile MD LLC (Indianapolis, IN), Assurance Health Indianapolis, LLC (Indianapolis, IN) and Psychiatric Management Services (Anderson, IN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeremy Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeremy Sullivan was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.