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JOSEPH R SULLIVAN D.O.
NPI 1295022903
Surgery in St Francis, WI

Active since July 01, 2011PECOS EnrolledAccepts Medicare Assignment
2000 E LAYTON AVE, ST FRANCIS, WI 53235(414) 744-6589 Get Directions Write a Review

NPPES record last updated: February 6, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 6, 2024, Feb 2, 2023, Nov 24, 2021 and 1 more (4 updates tracked since 2016).

About Joseph R Sullivan D.o. NPPES

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

JOSEPH R SULLIVAN D.O. (NPI 1295022903) is an individual surgery provider in St Francis, Wisconsin, licensed in Wisconsin (65368-21) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with Deaconess Hospital Inc, and is a graduate of Lincoln Mem Univ, Debusk Col Of Osteopathic Med (2011).

NPPES Registry Identity

NPI1295022903
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJOSEPH R SULLIVANCredential: D.O.
Location Address2000 E LAYTON AVESt Francis, WI 53235-6053
Mailing Address2000 E Layton AveSt Francis, WI 53235-6053 · (414) 744-6589
Phone(414) 744-6589
Sole ProprietorNo
Medical School CMSLincoln Mem Univ, Debusk Col Of Osteopathic MedGraduated 2011
Enumeration DateJuly 1, 2011
Last NPPES UpdateFebruary 6, 20244 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2024
✔ NPI 1295022903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in WI · 65368-21✔ Licensed in MI · 5101019532
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
2000 E LAYTON AVE, St Francis, WI 53235
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Other Identifiers 1

Medicaid100058377WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Joseph R Sullivan D.o. 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 ID4284923327
PECOS Enrollment IDI20160720002703, I20231107000927
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 6

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.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
43 services43 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
33 services32 patients
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.
31 services26 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
28 services22 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
15 services13 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Deaconess Hospital Inc

Acute Care Hospitals · Evansville, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150082
Location600 Mary StEvansville, IN 47710 · Vanderburgh County
Emergency services

Memorial Hospital And Health Care Center

Acute Care Hospitals · Jasper, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150115
Location800 W 9th StJasper, IN 47546 · Dubois County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53235 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

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.

EDWARD ST VILLE M.D
Radiology (Diagnostic Radiology)
2000 E LAYTON AVE
ST FRANCIS, WI 53235
Milwaukee County (414) 744-6589
KATELYN VANA HAASCH PA-C
Physician Assistant
2000 E LAYTON AVE
ST FRANCIS, WI 53235
Milwaukee County (414) 744-7880
ALEXANDRIA JOHNSON DPT
Physical Therapist
2000 E LAYTON AVE
ST FRANCIS, WI 53235
Milwaukee County (414) 747-8400
DR. MASSIHULLAH HAMIDI M.D., PH.D.
Radiology (Diagnostic Radiology)
2000 E LAYTON AVE
ST FRANCIS, WI 53235
Milwaukee County (414) 744-6589
RICHARD M. HAYES M.D.
Internal Medicine
2000 E LAYTON AVE
SAINT FRANCIS, WI 53235
Milwaukee County (414) 744-6589
HERSLOF'S, INC
Technician/Technologist (Optician)
2000 E LAYTON AVE, SUITE 110
MILWAUKEE, WI 53235
Milwaukee County (414) 481-8107
CHRISTOPHER DIMINO
Specialist/Technologist (Athletic Trainer)
2000 E LAYTON AVE
SAINT FRANCIS, WI 53235
Milwaukee County (608) 575-2799
KARIN LEE WASIULLAH FNP
Nurse Practitioner (Family)
2000 E LAYTON AVE
ST FRANCIS, WI 53235
Milwaukee County (414) 744-6589

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 Joseph Sullivan's NPI number?

The NPI number for Joseph Sullivan is 1295022903. It was assigned to this individual provider in the NPPES registry on July 1, 2011.

Where is Joseph Sullivan located?

Joseph Sullivan practices at 2000 E Layton Ave, St Francis, WI 53235. The listed phone number is (414) 744-6589.

What is Joseph Sullivan's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Joseph Sullivan enrolled in Medicare?

Yes. Joseph 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 Joseph Sullivan accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Aspirus Health Plan and 9 other insurers list Joseph 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.

Is Joseph Sullivan affiliated with any hospitals?

According to CMS data, Joseph Sullivan is affiliated with Deaconess Hospital Inc and Memorial Hospital And Health Care Center.

When was this NPI record last updated?

The NPPES record for Joseph Sullivan was last updated on February 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.