LISA MARIE SULLIVAN APRN-CNP
NPI 1063255164
Nurse Practitioner - Primary Care in Yukon, OK

Q: What is Lisa Sullivan's NPI number?

The NPI number for Lisa Sullivan is 1063255164. It was assigned to this individual provider in the NPPES registry on June 17, 2024.

Q: What is Lisa Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Sullivan was last updated on February 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.

Active since June 17, 2024PECOS EnrolledAccepts Medicare Assignment

1491 HEALTH CENTER PKWY, YUKON, OK 73099(405) 806-2200(405) 806-2207 Get Directions Write a Review

NPPES record last updated: February 9, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 26, 2024, Jun 17, 2024 (2 updates tracked since 2024).

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About Lisa Marie Sullivan Aprn-cnp NPPES

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

LISA MARIE SULLIVAN APRN-CNP (NPI 1063255164) is an individual primary care provider in Yukon, Oklahoma, licensed in Oklahoma (220736) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with Integris Southwest Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1063255164

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameLISA MARIE SULLIVANCredential: APRN-CNP

Location Address1491 HEALTH CENTER PKWYYukon, OK 73099-6492

Mailing Address1491 Health Center PkwyYukon, OK 73099-6492 · (405) 806-2200 · Fax (405) 806-2207

Phone(405) 806-2200

Fax(405) 806-2207

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJune 17, 2024

Last NPPES UpdateFebruary 9, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 9, 2026

✔ NPI 1063255164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in OK · 220736

1491 HEALTH CENTER PKWY, Yukon, OK 73099

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, Mending Health, UnitedHealthcare.Insurance ›

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

Lisa Marie Sullivan Aprn-cnp 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 ID2163951286

PECOS Enrollment IDI20250130000604

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.

Hospital Affiliations CMS Care Compare 3

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

Integris Southwest Medical Center

Acute Care Hospitals · Oklahoma City, OK

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370106

Location4401 South Western AvenueOklahoma City, OK 73109 · Oklahoma County

Emergency services Birthing friendly

Community Hospital, LLC

Acute Care Hospitals · Oklahoma City, OK

5/5 CMS rating

OwnershipPhysician

CMS Certification Number370203

Location3100 Southwest 89th StreetOklahoma City, OK 73159 · Oklahoma County

Emergency services

Integris Canadian Valley Hospital

Acute Care Hospitals · Yukon, OK

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370211

Location1201 Health Center ParkwayYukon, OK 73099 · Canadian County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73099 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

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$94.27 typical visit price

range $16.68 – $132.40

Typical copayment $23.56 (range $4.17 – $33.10)

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.

Other Providers at the Same Location NPPES 8

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

AQUILO MEDICAL HOME TEAM LLC

Family Medicine