SONNY SULLIVAN PA-C
NPI 1215610779
Physician Assistant in Clinton Twp, MI
About Sonny Sullivan Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SONNY SULLIVAN PA-C (NPI 1215610779) is an individual physician assistant in Clinton Twp, Michigan, licensed in Michigan (5601011968) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
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
Sonny 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48038 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
CLINTON TOWNSHIP, MI 48038
CLINTON TWP, MI 48038
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 Sonny Sullivan's NPI number?
The NPI number for Sonny Sullivan is 1215610779. It was assigned to this individual provider in the NPPES registry on August 10, 2023.
Where is Sonny Sullivan located?
Sonny Sullivan practices at 15855 19 Mile Rd, Clinton Twp, MI 48038. The listed phone number is (800) 532-2411.
What is Sonny Sullivan's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Sonny Sullivan enrolled in Medicare?
Yes. Sonny 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 Sonny Sullivan accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Sonny 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.
When was this NPI record last updated?
The NPPES record for Sonny Sullivan was last updated on April 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.
# Sonny Sullivan, PA-C · NPI 1215610779
Physician Assistant physician in Clinton Twp, Michigan. Individual provider, active in the CMS NPPES registry since August 10, 2023.
## Identity
- **NPI:** 1215610779 (Entity type: Individual)
- **Enumerated:** August 10, 2023
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** 5601011968 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 15855 19 MILE RD, Clinton Twp, MI 48038-3504
- **Phone:** (800) 532-2411
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** April 14, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1215610779) · Data from the CMS NPPES public registry.