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MICHAEL PATRICK SULLIVAN MD
NPI 1336105626
Psychiatry & Neurology - Neurology in So Lake Tahoe, CA

Active since April 25, 2006PECOS Enrolled
45.13/100
CMS Quality Rating
2101 SOUTH AVE, SO LAKE TAHOE, CA 96150(530) 542-5744(530) 542-5747 Get Directions Write a Review

NPPES record last updated: September 28, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Michael Patrick Sullivan Md NPPES

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

MICHAEL PATRICK SULLIVAN MD (NPI 1336105626) is an individual neurology provider in So Lake Tahoe, California, licensed in California (G40941) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336105626
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameMICHAEL PATRICK SULLIVANCredential: MD
Location Address2101 SOUTH AVESo Lake Tahoe, CA 96150
Mailing Address2101 South AveSo Lake Tahoe, CA 96150 · (530) 542-5744 · Fax (530) 542-5747
Phone(530) 542-5744
Fax(530) 542-5747
Sole ProprietorYes
Enumeration DateApril 25, 2006
Last NPPES UpdateSeptember 28, 2012
✔ NPI 1336105626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Licenses✔ Licensed in CA · G40941✔ Licensed in NV · 6833
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
2101 SOUTH AVE, So Lake Tahoe, CA 96150
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Other Identifiers 3

Medicare UPINA48403
Medicaid00G409410CA
Medicare ID-Type Unspecified00G409410

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Patrick Sullivan Md 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

2

Medicare enrollment records show Michael Sullivan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Tahoe Carson Valley Medical Group Inc
0.2 mi
Family Medicine
2170 SOUTH AVE
South Lake Tahoe, CA 96150
  • Reassigned Medicare billing, California enrollment
  • 100 clinicians in this Medicare group
NPI 1508865528 (530) 541-3420
Barton Healthcare System
0.2 mi
General Acute Care Hospital
2170 SOUTH AVE
South Lake Tahoe, CA 96150
  • Reassigned Medicare billing, California enrollment
  • 126 clinicians in this Medicare group
NPI 1003867565 (530) 541-3420

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 96150 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
$137.20 typical visit price
range $60.44 – $180.85
Typical copayment $34.30 (range $15.11 – $45.21)
Most-billed visit code 99204
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

45.13/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality7.09
Promoting Interoperability100
Improvement Activities20
Cost35

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$55.72 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Michael Sullivan's NPI number?

The NPI number for Michael Sullivan is 1336105626. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Where is Michael Sullivan located?

Michael Sullivan practices at 2101 South Ave, So Lake Tahoe, CA 96150. The listed phone number is (530) 542-5744.

What is Michael Sullivan's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Michael Sullivan enrolled in Medicare?

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

Which organizations bill Medicare for Michael Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Sullivan reassigns Medicare benefits to 2 organizations: Tahoe Carson Valley Medical Group Inc (South Lake Tahoe, CA) and Barton Healthcare System (South Lake Tahoe, CA). 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 Michael Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Michael Sullivan was last updated on September 28, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.