DR. JOHN PAUL SULLIVAN M.D.
NPI 1356355531
Psychiatry & Neurology - Child & Adolescent Psychiatry in Louisville, KY

NPI Status: Active since July 27, 2006

Contact Information

4011 GARDINER POINT DR STE 101
LOUISVILLE, KY
ZIP 40213
Phone: (502) 451-5121
Fax: (502) 451-5125

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  • Individual
  • Male
  • Years of Experience 47
  • Psychiatry & Neurology
  • Child & Adolescent Psychiatry
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JOHN SULLIVAN

This page provides the complete NPI Profile along with additional information for John Sullivan, a provider established in Louisville, Kentucky with a medical specialization in Psychiatry & Neurology, focusing in child & adolescent psychiatry and more than 47 years of experience. He graduated from University Of Louisville School Of Medicine in 1980. The healthcare provider is registered in the NPI registry with number 1356355531 assigned on July 2006. The practitioner's primary taxonomy code is 2084P0804X with license number KY21704 (KY). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1356355531
Provider Name
DR. JOHN PAUL SULLIVAN M.D.
Gender
Male
Entity Type
Individual
Location Address
4011 GARDINER POINT DR STE 101 LOUISVILLE, KY 40213
Location Phone
(502) 451-5121
Location Fax
(502) 451-5125
Mailing Address
4011 GARDINER POINT DR STE 101 LOUISVILLE, KY 40213
Mailing Phone
(502) 451-5121
Mailing Fax
(502) 451-5125
Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Graduation Year
1980
Is Sole Proprietor?
Yes
Enumeration Date
07-27-2006
Last Update Date
01-09-2020
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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

Psychiatry & Neurology Child & Adolescent Psychiatry

Taxonomy Code
2084P0804X
Type
Allopathic & Osteopathic Physicians
License No.
KY21704
License State
KY
Taxonomy Description
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

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)
12084P0800XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Psychiatry

KY21704 (KY)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • 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
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - 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
100012920AMEDICAID (05)IN 
64217045MEDICAID (05)KY 

Medicare Participation & PECOS Enrollment Status

John Sullivan is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

John 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

  • PECOS PAC ID: 1850567439

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20120103000486

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 90 times for 15 patients

Reviews for DR. JOHN PAUL SULLIVAN M.D.

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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 1356355531, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

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.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
6
Unchanged
Pos 5
3
Doubled → 6
Pos 6
5
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
5
Unchanged
Pos 9
3
Doubled → 6
Check
1
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 5 → 10 → 1 3 → 6 5 → 10 → 1 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 0 + 6 + 6 + 5 + 1 + 0 + 5 + 6 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1356355531.

Other Providers at the Same Location


The following 8 providers are registered at the same or a nearby location.

Nurse Practitioner (Psychiatric/Mental Health)
4011 GARDINER POINT DR STE 101
LOUISVILLE, KY 40213
Social Worker (Clinical)
4011 GARDINER POINT DR STE 101
LOUISVILLE, KY 40213
Nurse Practitioner (Psychiatric/Mental Health)
4011 GARDINER POINT DR STE 101
LOUISVILLE, KY 40213
Nurse Practitioner (Psychiatric/Mental Health)
4011 GARDINER POINT DR STE 101
LOUISVILLE, KY 40213
Psychiatry & Neurology (Child & Adolescent Psychiatry)
4011 GARDINER POINT DR STE 101
LOUISVILLE, KY 40213
Nurse Practitioner (Psychiatric/Mental Health)
4011 GARDINER POINT DR STE 101
LOUISVILLE, KY 40213
Nurse Practitioner (Psychiatric/Mental Health)
4011 GARDINER POINT DR STE 101
LOUISVILLE, KY 40213
Psychiatry & Neurology (Child & Adolescent Psychiatry)
4011 GARDINER POINT DR STE 101
LOUISVILLE, KY 40213

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356355531, enumerated as an "individual" on July 27, 2006.

The provider is located at 4011 GARDINER POINT DR STE 101 LOUISVILLE, KY 40213 and the phone number is (502) 451-5121.

Psychiatry & Neurology with taxonomy code 2084P0804X and a focus in Child & Adolescent Psychiatry.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.