LISA SULLIVAN PA-C
NPI 1184400335
Physician Assistant in Vadnais Heights, MN

Q: What is Lisa Sullivan's NPI number?

The NPI number for Lisa Sullivan is 1184400335. It was assigned to this individual provider in the NPPES registry on September 5, 2023.

Q: What is Lisa Sullivan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Sullivan was last updated on November 10, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 05, 2023PECOS EnrolledAccepts Medicare Assignment

3580 ARCADE ST, VADNAIS HEIGHTS, MN 55127(651) 968-5201(651) 968-5903 Get Directions Write a Review

NPPES record last updated: November 10, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 10, 2025, Sep 9, 2023 (2 updates tracked since 2023).

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About Lisa Sullivan Pa-c NPPES

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

LISA SULLIVAN PA-C (NPI 1184400335) is an individual physician assistant in Vadnais Heights, Minnesota, licensed in Minnesota (14637) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS, is affiliated with M Health Fairview Southdale Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1184400335

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameLISA SULLIVANCredential: PA-C

Location Address3580 ARCADE STVadnais Heights, MN 55127-7135

Mailing Address710 Commerce Dr Ste 200Woodbury, MN 55125-4925 · (651) 968-5201 · Fax (651) 968-5903

Phone(651) 968-5201

Fax(651) 968-5903

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateSeptember 5, 2023

Last NPPES UpdateNovember 10, 20252 updates tracked since enumeration

NPPES CertifiedNovember 10, 2025

✔ NPI 1184400335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MN · 14637

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3580 ARCADE ST, Vadnais Heights, MN 55127

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.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 Sullivan Pa-c 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 ID2264878610

PECOS Enrollment IDI20240308000231

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 2

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.

78 services63 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.

29 services24 patients

Hospital Affiliations CMS Care Compare 2

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

M Health Fairview Southdale Hospital

Acute Care Hospitals · Edina, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240078

Location6401 France Avenue SouthEdina, MN 55435 · Hennepin County

Emergency services Birthing friendly

M Health Fairview Ridges Hospital

Acute Care Hospitals · Burnsville, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number240207

Location201 East Nicollet BoulevardBurnsville, MN 55337 · Dakota County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55127 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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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.

MRS. TAWNEY R MAUL CNP

Nurse Practitioner (Family)