MIKAELYN SULLIVAN
NPI 1154918092
Nurse Practitioner - Family in Dallas, TX

Q: What is Mikaelyn Sullivan's NPI number?

The NPI number for Mikaelyn Sullivan is 1154918092. It was assigned to this individual provider in the NPPES registry on December 27, 2020.

Q: What is Mikaelyn Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Mikaelyn Sullivan was last updated on November 23, 2021. 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.

Active since December 27, 2020PECOS EnrolledAccepts Medicare Assignment

4055 VALLEY VIEW LN STE 400, DALLAS, TX 75244(972) 715-3800 Get Directions Write a Review

NPPES record last updated: November 23, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 23, 2021, Dec 27, 2020 (2 updates tracked since 2020).

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About Mikaelyn Sullivan NPPES

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

MIKAELYN SULLIVAN (NPI 1154918092) is an individual family provider in Dallas, Texas, licensed in Colorado (APN.0996096-NP) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1154918092

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMIKAELYN SULLIVAN

Location Address4055 VALLEY VIEW LN STE 400Dallas, TX 75244-5071

Mailing Address940 Central Park Dr, Ste 101Steamboat Springs, CO 80487-8853 · (972) 715-3800

Phone(972) 715-3800

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateDecember 27, 2020

Last NPPES UpdateNovember 23, 20212 updates tracked since enumeration

NPPES CertifiedNovember 23, 2021

✔ NPI 1154918092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LF0000X

License✔ Licensed in CO · APN.0996096-NP

4055 VALLEY VIEW LN STE 400, Dallas, TX 75244

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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

Mikaelyn Sullivan 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 ID9638572209

PECOS Enrollment IDI20210721000671

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75244 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

$88.19 typical visit price

range $57.18 – $172.86

Typical copayment $22.04 (range $14.29 – $43.21)

Most-billed visit code 99203

Established Patient

$100.80 typical visit price

range $18.48 – $141.20

Typical copayment $25.20 (range $4.62 – $35.30)

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 20

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

GERILYN MEANY APRN

Nurse Practitioner (Family)