SULLIVAN MEDICAL CLINIC, LLC
NPI 1205263159
Internal Medicine - Addiction Medicine in Milwaukee, WI

Q: What is Sullivan Medical Clinic, LLC's NPI number?

The NPI number for Sullivan Medical Clinic, LLC is 1205263159. It was assigned to this organization in the NPPES registry on October 7, 2013.

Q: What is Sullivan Medical Clinic, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

Active since October 07, 2013

6040 W LISBON AVE, SUITE 200, MILWAUKEE, WI 53210(414) 447-9890(414) 447-9891 Get Directions Write a Review

NPPES record last updated: October 7, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Sullivan Medical Clinic, Llc NPPES

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

SULLIVAN MEDICAL CLINIC, LLC (NPI 1205263159) is a healthcare organization registered as an addiction medicine in Milwaukee, Wisconsin and active in the NPI registry since October 2013. The organization lists Gerald E Sullivan, Sole Mbr, as its authorized official.

NPPES Registry Identity

NPI1205263159

Entity TypeOrganization

Primary Taxonomy207RA0401X

Legal Business NameSULLIVAN MEDICAL CLINIC, LLC

Location Address6040 W LISBON AVE, SUITE 200Milwaukee, WI 53210-2116

Mailing Address6040 W Lisbon Ave, Suite 200Milwaukee, WI 53210-2116 · (414) 447-9890 · Fax (414) 447-9891

Phone(414) 447-9890

Fax(414) 447-9891

Organization SubpartNo

Authorized OfficialGerald E SullivanSole Mbr · (414) 447-9890

Enumeration DateOctober 7, 2013

✔ NPI 1205263159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RA0401X

Definition

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

6040 W LISBON AVE, Milwaukee, WI 53210

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sullivan Medical Clinic, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sullivan Medical Clinic, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Gerald Sullivan, M.D.

Internal Medicine

NPI 1760683551

6040 W LISBON AVE SUITE 200
Milwaukee, WI 53210

(414) 447-9890

✔ PECOSSame address

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

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 Sullivan Medical Clinic, LLC's NPI number?

The NPI number for Sullivan Medical Clinic, LLC is 1205263159. It was assigned to this organization in the NPPES registry on October 7, 2013.

Where is Sullivan Medical Clinic, LLC located?

Sullivan Medical Clinic, LLC is located at 6040 W Lisbon Ave Suite 200, Milwaukee, WI 53210. The listed phone number is (414) 447-9890.

What is Sullivan Medical Clinic, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

Is Sullivan Medical Clinic, LLC enrolled in Medicare?

Yes. Sullivan Medical Clinic, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sullivan Medical Clinic, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Sullivan Medical Clinic, LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Sullivan Medical Clinic, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Sullivan Medical Clinic, LLC 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 Sullivan Medical Clinic, LLC was last updated on October 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.