MICHAEL E SULLIVAN M.D.
NPI 1093883142
Family Medicine in Watertown, WI

Active since November 30, 2006PECOS EnrolledAccepts Medicare Assignment
127 HOSPITAL DR, WATERTOWN, WI 53098(920) 261-8500 Get Directions Write a Review

NPPES record last updated: April 7, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Michael E Sullivan M.d. NPPES

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

MICHAEL E SULLIVAN M.D. (NPI 1093883142) is an individual family medicine provider in Watertown, Wisconsin, licensed in Wisconsin (46656) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2001).

NPPES Registry Identity

NPI1093883142
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMICHAEL E SULLIVANCredential: M.D.
Location Address127 HOSPITAL DRWatertown, WI 53098-3303
Mailing Address127 Hospital DrWatertown, WI 53098-3303 · (920) 261-8500 · Fax (920) 261-8828
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2001
Enumeration DateNovember 30, 2006
Last NPPES UpdateApril 7, 2022
NPPES CertifiedApril 7, 2022
NPI 1093883142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in WI · 46656
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
127 HOSPITAL DR, Watertown, WI 53098

Other Identifiers 1

Medicaid34560600WI

Accepted 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

Michael E Sullivan M.d. 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 ID1153308887
PECOS Enrollment IDI20040701000385
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.

Areas of Expertise CMS Part B claims 17

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.

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.
487 services227 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
204 services204 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
173 services67 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
143 services106 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
110 services48 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
109 services95 patients

Hospital Affiliations CMS Care Compare 3

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

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520008
Location725 American AveWaukesha, WI 53188 · Waukesha County
Emergency services Birthing friendly

Fort Memorial Hospital

Acute Care Hospitals · Fort Atkinson, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number520071
Location611 Sherman Ave EFort Atkinson, WI 53538 · Jefferson County
Emergency services Birthing friendly

Watertown Memorial Hospital

Acute Care Hospitals · Watertown, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520116
Location125 Hospital DriveWatertown, WI 53098 · Dodge County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53098 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers30 claims112 services$5.26 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers14 claims22 services$0.83 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers28 claims28 services$114.68 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
2 suppliers24 claims24 services$36.61 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 14

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

Family Medicine
127 HOSPITAL DR
WATERTOWN, WI 53098
Family Medicine
127 HOSPITAL DR
WATERTOWN, WI 53098
Family Medicine
127 HOSPITAL DR
WATERTOWN, WI 53098
Physician Assistant (Medical)
127 HOSPITAL DR
WATERTOWN, WI 53098
Family Medicine
127 HOSPITAL DR
WATERTOWN, WI 53098
Nurse Practitioner
127 HOSPITAL DR
WATERTOWN, WI 53098
Physician Assistant
127 HOSPITAL DR
WATERTOWN, WI 53098
Family Medicine
127 HOSPITAL DR
WATERTOWN, WI 53098

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 Michael Sullivan's NPI number?

The NPI number for Michael Sullivan is 1093883142. It was assigned to this individual provider in the NPPES registry on November 30, 2006.

Where is Michael Sullivan located?

Michael Sullivan practices at 127 Hospital Dr, Watertown, WI 53098. The listed phone number is (920) 261-8500.

What is Michael Sullivan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Michael Sullivan enrolled in Medicare?

Yes. Michael Sullivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Sullivan accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Group Health Cooperative-SCW, MercyCare Health Plans and Network Health and 2 other insurers list Michael 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.

Is Michael Sullivan affiliated with any hospitals?

According to CMS data, Michael Sullivan is affiliated with Waukesha Memorial Hospital, Fort Memorial Hospital and Watertown Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Michael Sullivan was last updated on April 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.