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KATHLEEN M. SULLIVAN APRN
NPI 1306095955
Nurse Practitioner - Psychiatric/Mental Health in Lago Vista, TX

Active since September 18, 2008PECOS Enrolled
20511 SUNSET LN, LAGO VISTA, TX 78645(860) 460-1211(860) 760-6113 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 19, 2026, Sep 11, 2018 (2 updates tracked since 2018).

About Kathleen M. Sullivan Aprn NPPES

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

KATHLEEN M. SULLIVAN APRN (NPI 1306095955) is an individual psychiatric/mental health provider in Lago Vista, Texas, licensed in Rhode Island (NPP37789) and active in the NPI registry since September 2008. She is enrolled in Medicare PECOS and maintains a secondary practice location in Cranston.

NPPES Registry Identity

NPI1306095955
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKATHLEEN M. SULLIVANCredential: APRN
Location Address20511 SUNSET LNLago Vista, TX 78645-6245
Mailing Address20511 Sunset LnLago Vista, TX 78645-6245 · (860) 460-1211 · Fax (860) 460-1211
Phone(860) 460-1211
Fax(860) 760-6113
Sole ProprietorYes
Enumeration DateSeptember 18, 2008
Last NPPES UpdateMay 19, 20262 updates tracked since enumeration
NPPES CertifiedMay 19, 2026
✔ NPI 1306095955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in RI · NPP37789✔ Licensed in CT · 3862
20511 SUNSET LN, Lago Vista, TX 78645
Open in Google Maps ↗

Secondary Practice Location 1

Location 195 Sockanosset Cross Rd Ste 305Cranston, RI 02920-5559 · Phone (401) 946-6400 · Fax (833) 428-5010

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathleen M. Sullivan Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

4

Medicare enrollment records show Kathleen Sullivan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Stokes Counseling Services LLC
1,584 mi
Professional
16 HILLSIDE AVE
Naugatuck, CT 06770
  • Reassigned Medicare billing, Connecticut enrollment
  • 143 clinicians in this Medicare group
NPI 1134541469 (203) 572-2962
Cornerstone Counseling Center
1,584 mi
Professional
106 DEEPWOOD DR
Waterbury, CT 06708
  • Reassigned Medicare billing, Connecticut enrollment
  • 22 clinicians in this Medicare group
NPI 1316486889 (860) 877-2250
Coos County Oregon
1,695 mi
Clinic/Center
281 LACLAIR STREET
Coos Bay, OR 97420
  • Reassigned Medicare billing, Oregon enrollment
  • 24 clinicians in this Medicare group
NPI 1811981053 (541) 266-6700
Peninsula Behavioral Health
1,814 mi
Community/Behavioral Health
118 E 8TH ST
Port Angeles, WA 98362
  • Reassigned Medicare billing, Washington enrollment
  • 35 clinicians in this Medicare group
NPI 1760519060 (360) 457-0431

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78645 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
$89.03 typical visit price
range $57.88 – $174.00
Typical copayment $22.25 (range $14.47 – $43.50)
Most-billed visit code 99203
Established Patient
$101.65 typical visit price
range $18.88 – $142.23
Typical copayment $25.41 (range $4.72 – $35.55)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kathleen Sullivan's NPI number?

The NPI number for Kathleen Sullivan is 1306095955. It was assigned to this individual provider in the NPPES registry on September 18, 2008.

Where is Kathleen Sullivan located?

Kathleen Sullivan practices at 20511 Sunset Ln, Lago Vista, TX 78645. The listed phone number is (860) 460-1211.

What is Kathleen Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kathleen Sullivan enrolled in Medicare?

Yes. Kathleen Sullivan is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kathleen Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Sullivan reassigns Medicare benefits to 4 organizations: Stokes Counseling Services LLC (Naugatuck, CT), Cornerstone Counseling Center (Waterbury, CT), Coos County Oregon (Coos Bay, OR) and Peninsula Behavioral Health (Port Angeles, WA). Each 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 Kathleen Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kathleen Sullivan accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Kathleen 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 Kathleen Sullivan was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.