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JAMIE SULLIVAN CRNP
NPI 1407353717
Nurse Practitioner - Psychiatric/Mental Health in Honesdale, PA

Active since April 12, 2018PECOS EnrolledAccepts Medicare Assignment
600 MAPLE AVE STE 15, HONESDALE, PA 18431(570) 253-8219 Get Directions Write a Review

NPPES record last updated: April 12, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jamie Sullivan Crnp NPPES

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

JAMIE SULLIVAN CRNP (NPI 1407353717) is an individual psychiatric/mental health provider in Honesdale, Pennsylvania, licensed in Pennsylvania (SP018680) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1407353717
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJAMIE SULLIVANCredential: CRNP
Location Address600 MAPLE AVE STE 15Honesdale, PA 18431-1460
Mailing Address601 Park StHonesdale, PA 18431-1445 · (570) 253-8219
Phone(570) 253-8219
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateApril 12, 2018
✔ NPI 1407353717 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
License✔ Licensed in PA · SP018680
600 MAPLE AVE STE 15, Honesdale, PA 18431
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jamie Sullivan Crnp 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 ID3173887767
PECOS Enrollment IDI20180508000079
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 Reassignment

Medicare enrollment records show Jamie Sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Moonshot Psychiatric Nurse Practitioner PC
2,323 mi
Psychiatric/Mental Health
4803 FREMONT AVE N
Seattle, WA 98103
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 17 clinicians in this Medicare group
NPI 1669158879 (855) 444-7258

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 18431 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMOTHY GLADSON LPC
Counselor (Professional)
600 MAPLE AVE STE 15
HONESDALE, PA 18431
Wayne County (570) 253-8219
MR. JOSEPH UNGVARSKY JR. PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
600 MAPLE AVE STE 15
HONESDALE, PA 18431
Wayne County (570) 253-8219
MRS. DANNIELLE S WILMOT LSW
Social Worker (Clinical)
600 MAPLE AVE STE 15
HONESDALE, PA 18431
Wayne County (570) 253-8219
EILEEN JAYNE ARENSON NP
Nurse Practitioner
600 MAPLE AVE STE 15
HONESDALE, PA 18431
Wayne County (570) 253-8219
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Clinic/Center (Federally Qualified Health Center (FQHC))
600 MAPLE AVE STE 15
HONESDALE, PA 18431
Wayne County (570) 253-8219
FERNEY PAEZ OLMOS M.D.
Psychiatry & Neurology (Psychiatry)
600 MAPLE AVE STE 15
HONESDALE, PA 18431
Wayne County (570) 253-8219

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 Jamie Sullivan's NPI number?

The NPI number for Jamie Sullivan is 1407353717. It was assigned to this individual provider in the NPPES registry on April 12, 2018.

Where is Jamie Sullivan located?

Jamie Sullivan practices at 600 Maple Ave Ste 15, Honesdale, PA 18431. The listed phone number is (570) 253-8219.

What is Jamie Sullivan's specialty?

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

Is Jamie Sullivan enrolled in Medicare?

Yes. Jamie 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.

Which organization bills Medicare for Jamie Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jamie Sullivan reassigns Medicare benefits to Moonshot Psychiatric Nurse Practitioner PC (Seattle, WA). The 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 Jamie 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 Jamie Sullivan was last updated on April 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.