MICHAEL W. SULLIVAN M.D.
NPI 1275576944
General Practice in Fort Knox, KY
NPI Status: Active since June 13, 2006
Contact Information
1600 SPEARHEAD DIVISION AVE DEPT 140
FORT KNOX, KY
ZIP 40122
Phone: (502) 613-4605
Fax: (502) 613-4549
- Individual
- Male
- General Practice
- Accepts Insurance
- PECOS Enrolled
About MICHAEL SULLIVAN
This page provides the complete NPI Profile along with additional information for Michael Sullivan, a primary care provider established in Fort Knox, Kentucky with a medical specialization in General Practice. The healthcare provider is registered in the NPI registry with number 1275576944 assigned on June 2006. The practitioner's primary taxonomy code is 208D00000X with license number 30828 (KY). The provider is registered as an individual and his NPI record was last updated 12 years ago.
- NPI
- 1275576944
- Provider Name
- MICHAEL W. SULLIVAN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1600 SPEARHEAD DIVISION AVE DEPT 140 FORT KNOX, KY 40122
- Location Phone
- (502) 613-4605
- Location Fax
- (502) 613-4549
- Mailing Address
- 1600 SPEARHEAD DIVISION AVE DEPT 140 FORT KNOX, KY 40122
- Mailing Phone
- (502) 613-4605
- Mailing Fax
- (502) 613-4549
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-13-2006
- Last Update Date
- 06-24-2014
- Code Navigator
A primary care provider (PCP) like Michael Sullivan sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Practice
- Taxonomy Code
- 208D00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 30828
- License State
- KY
- Taxonomy Description
- A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | 20770 (NE) |
| 2 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 37645020 (WI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - EPO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Bronze + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Elevate by Medica Bronze $0 Copay PCP Visits - EPO
- Elevate by Medica Bronze Premier - EPO
- Elevate by Medica Expanded Bronze Standard - EPO
- Elevate by Medica Gold $0 Copay PCP Visits - EPO
- Elevate by Medica Gold Share - EPO
- Elevate by Medica Gold Standard - EPO
- Elevate by Medica Silver $0 Copay PCP Visits - EPO
- Elevate by Medica Silver Share - EPO
- Elevate by Medica Silver Standard - EPO
- Medica Insure Bronze Premier - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 47600743612 | MEDICAID (05) | NE | |
| 47600743621 | MEDICAID (05) | NE | |
| 47600743622 | MEDICAID (05) | NE | |
| G27320 | MEDICARE UPIN (02) | ||
| 47600743623 | MEDICAID (05) | NE |
Medicare Participation & PECOS Enrollment Status
Michael Sullivan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1275576944, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275576944, enumerated as an "individual" on June 13, 2006.
The provider is located at 1600 SPEARHEAD DIVISION AVE DEPT 140 FORT KNOX, KY 40122 and the phone number is (502) 613-4605.
General Practice with taxonomy code 208D00000X.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to verify.
