MALLORY SULLIVAN DO
NPI 1124311360
Family Medicine in Waterville, NY

Active since May 20, 2011PECOS EnrolledAccepts Medicare Assignment
78.7/100
CMS Quality Rating
117 W MAIN ST, SUITE 1, WATERVILLE, NY 13480(315) 841-4178(315) 841-4338 Get Directions Write a Review

NPPES record last updated: March 20, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mallory Sullivan Do NPPES

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

MALLORY SULLIVAN DO (NPI 1124311360) is an individual family medicine provider in Waterville, New York, licensed in New York (274601) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS, is affiliated with Ascension Sacred Heart Bay, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2011).

NPPES Registry Identity

NPI1124311360
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMALLORY SULLIVANCredential: DO
Location Address117 W MAIN ST, SUITE 1Waterville, NY 13480-1165
Mailing Address117 W Main St, Suite 1Waterville, NY 13480-1165 · (315) 841-4178 · Fax (315) 841-4338
Fax(315) 841-4338
Sole ProprietorNo
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2011
Enumeration DateMay 20, 2011
Last NPPES UpdateMarch 20, 2017
NPI 1124311360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in NY · 274601
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.
117 W MAIN ST, Waterville, NY 13480

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

Mallory Sullivan Do 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 ID5395989073
PECOS Enrollment IDI20140731001674
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 5

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 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.
157 services104 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.
104 services104 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.
53 services43 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
25 services23 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
18 services17 patients

Hospital Affiliations CMS Care Compare 3

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

Ascension Sacred Heart Bay

Acute Care Hospitals · Panama City, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100026
Location615 N Bonita AvePanama City, FL 32401 · Bay County
Emergency services

Wynn Hospital

Acute Care Hospitals · Utica, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330044
Location111 Hospital DriveUtica, NY 13502 · Oneida County
Emergency services Birthing friendly

Community Memorial Hospital, Inc

Critical Access Hospitals · Hamilton, NY
OwnershipVoluntary non-profit - Private
CMS Certification Number331316
Location150 Broad StreetHamilton, NY 13346 · Madison County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13480 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.7/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.73
Promoting Interoperability99
Improvement Activities40
Cost42.38

Referred Medical Equipment & Supplies CMS DME claims 6

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 suppliers28 claims65 services$6.40 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers15 claims20 services$1.14 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261
DME-Hospital Beds · category DB000N
1 supplier12 claims12 services$47.80 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$12.60 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
1 supplier27 claims27 services$65.92 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier18 claims18 services$21.28 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 7

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

Internal Medicine
117 W MAIN ST
WATERVILLE, NY 13480
Nurse Practitioner (Family)
117 W MAIN ST
WATERVILLE, NY 13480
Nurse Practitioner
117 W MAIN ST
WATERVILLE, NY 13480
Nurse Practitioner (Family)
117 W MAIN ST
WATERVILLE, NY 13480
Clinic/Center (Rural Health)
117 W MAIN ST
WATERVILLE, NY 13480
Nurse Practitioner (Family)
117 W MAIN ST
WATERVILLE, NY 13480
Family Medicine
117 W MAIN ST
WATERVILLE, NY 13480

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 Mallory Sullivan's NPI number?

The NPI number for Mallory Sullivan is 1124311360. It was assigned to this individual provider in the NPPES registry on May 20, 2011.

Where is Mallory Sullivan located?

Mallory Sullivan practices at 117 W Main St Suite 1, Waterville, NY 13480. The listed phone number is (315) 841-4178.

What is Mallory Sullivan's specialty?

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

Is Mallory Sullivan enrolled in Medicare?

Yes. Mallory 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.

Is Mallory Sullivan affiliated with any hospitals?

According to CMS data, Mallory Sullivan is affiliated with Ascension Sacred Heart Bay, Wynn Hospital and Community Memorial Hospital, Inc.

When was this NPI record last updated?

The NPPES record for Mallory Sullivan was last updated on March 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.