MRS. KELLY SULLIVAN APRN
NPI 1407694789
Nurse Practitioner - Family in Port Saint Lucie, FL

Q: What is Kelly Sullivan's NPI number?

The NPI number for Kelly Sullivan is 1407694789. It was assigned to this individual provider in the NPPES registry on July 19, 2024.

Q: What is Kelly Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Sullivan was last updated on July 19, 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.

Active since July 19, 2024PECOS Enrolled

10198 SW VILLAGE PKWY STE 105, PORT SAINT LUCIE, FL 34987(772) 934-4990 Get Directions Write a Review

NPPES record last updated: July 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mrs. Kelly Sullivan Aprn NPPES

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

MRS. KELLY SULLIVAN APRN (NPI 1407694789) is an individual family provider in Port Saint Lucie, Florida, licensed in Florida (11034152) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407694789

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. KELLY SULLIVANCredential: APRN

Location Address10198 SW VILLAGE PKWY STE 105Port Saint Lucie, FL 34987-2592

Mailing Address2598 Sw Dania StPort Saint Lucie, FL 34953-7307 · (561) 345-5343

Phone(772) 934-4990

Sole ProprietorNo

Enumeration DateJuly 19, 2024

NPPES CertifiedJuly 19, 2024

✔ NPI 1407694789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in FL · 11034152

10198 SW VILLAGE PKWY STE 105, Port Saint Lucie, FL 34987

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Kelly 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.

Areas of Expertise CMS Part B claims

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.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34987 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

$91.69 typical visit price

range $58.56 – $179.05

Typical copayment $22.92 (range $14.64 – $44.76)

Most-billed visit code 99203

Established Patient

$103.21 typical visit price

range $18.44 – $144.68

Typical copayment $25.80 (range $4.61 – $36.17)

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.

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Other Providers at the Same Location NPPES 3

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

FLEURA MAITRE

Physician Assistant

10198 SW VILLAGE PKWY STE 105
PORT ST LUCIE, FL 34987

St. Lucie County (718) 502-4588

TRADITION HEALTH AND WELLNESS CLINIC PLLC

Family Medicine

10198 SW VILLAGE PKWY STE 105
PORT ST LUCIE, FL 34987

St. Lucie County (772) 934-4990

MRS. ANN MARIE GONERA F.N.P.

Nurse Practitioner (Family)

10198 SW VILLAGE PKWY STE 105
PORT ST LUCIE, FL 34987

St. Lucie County (772) 934-4990

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 Kelly Sullivan's NPI number?

The NPI number for Kelly Sullivan is 1407694789. It was assigned to this individual provider in the NPPES registry on July 19, 2024.

Where is Kelly Sullivan located?

Kelly Sullivan practices at 10198 SW Village Pkwy Ste 105, Port Saint Lucie, FL 34987. The listed phone number is (772) 934-4990.

What is Kelly Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kelly Sullivan enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kelly Sullivan was last updated on July 19, 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.