SPENCER K SULLIVAN MD
NPI 1073735114
Pediatrics - Pediatric Hematology-Oncology in Madison, MS

Q: What is Spencer Sullivan's NPI number?

The NPI number for Spencer Sullivan is 1073735114. It was assigned to this individual provider in the NPPES registry on May 2, 2007.

Q: What is Spencer Sullivan's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Q: When was this NPI record last updated?

The NPPES record for Spencer Sullivan was last updated on April 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 May 02, 2007PECOS Enrolled

7730 OLD CANTON RD BLDG B, MADISON, MS 39110(601) 499-0935(601) 499-0936 Get Directions Write a Review

NPPES record last updated: April 14, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 30, 2024, Apr 18, 2024, Jun 18, 2019 (3 updates tracked since 2019).

On this page

About Spencer K Sullivan Md NPPES

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

SPENCER K SULLIVAN MD (NPI 1073735114) is an individual pediatric hematology-oncology provider in Madison, Mississippi, licensed in Mississippi (23304) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073735114

Entity TypeIndividualMale

Primary Taxonomy2080P0207X

Provider Legal NameSPENCER K SULLIVANCredential: MD

Location Address7730 OLD CANTON RD BLDG BMadison, MS 39110-9299

Mailing Address7731 Old Canton Rd Ste BMadison, MS 39110-6115 · (601) 499-0935 · Fax (601) 499-0936

Phone(601) 499-0935

Fax(601) 499-0936

Sole ProprietorNo

Enumeration DateMay 2, 2007

Last NPPES UpdateApril 14, 20253 updates tracked since enumeration

NPPES CertifiedApril 14, 2025

✔ NPI 1073735114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0207X

License✔ Licensed in MS · 23304

Definition

A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

7730 OLD CANTON RD BLDG B, Madison, MS 39110

Open in Google Maps ↗

Other Identifiers 1

Medicaid01212067MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Spencer K Sullivan Md 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 Reassignment

Medicare enrollment records show Spencer Sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medical Foundation Of Central Mississippi, Inc

1.9 mi

Cardiovascular Disease

401 BAPTIST DR, SUITE 304
Madison, MS 39110

Reassigned Medicare billing, Mississippi enrollment
423 clinicians in this Medicare group

NPI 1902096837 (601) 605-3531

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

Areas of Expertise CMS Part B claims 3

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.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

27 services15 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

20 services13 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

19 services14 patients

Other Providers at the Same Location NPPES 3

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

MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC

Durable Medical Equipment & Medical Supplies

7730 OLD CANTON RD BLDG B
MADISON, MS 39110

Madison County (601) 499-0935

DR. PATRICIA HONEA STEWART M.D.

Allergy & Immunology

7730 OLD CANTON RD BLDG B
MADISON, MS 39110

Madison County (601) 499-0935

DR. NATALIE ETHRIDGE RUDSENSKE MD

Allergy & Immunology

7730 OLD CANTON RD BLDG B
MADISON, MS 39110

Madison County (601) 499-0935

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 Spencer Sullivan's NPI number?

The NPI number for Spencer Sullivan is 1073735114. It was assigned to this individual provider in the NPPES registry on May 2, 2007.

Where is Spencer Sullivan located?

Spencer Sullivan practices at 7730 Old Canton Rd Bldg B, Madison, MS 39110. The listed phone number is (601) 499-0935.

What is Spencer Sullivan's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Is Spencer Sullivan enrolled in Medicare?

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

Which organization bills Medicare for Spencer Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Spencer Sullivan reassigns Medicare benefits to Medical Foundation Of Central Mississippi, Inc (Madison, MS). The 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 Spencer Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Spencer Sullivan accept?

Health plans from Cigna Healthcare list Spencer Sullivan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Spencer Sullivan was last updated on April 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.