KELLY ELIZABETH SULLIVAN AGNP-C
NPI 1427549088
Nurse Practitioner - Primary Care in Vernon, CT
About Kelly Elizabeth Sullivan Agnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY ELIZABETH SULLIVAN AGNP-C (NPI 1427549088) is an individual primary care provider in Vernon, Connecticut, licensed in Connecticut (390200000X) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly Elizabeth Sullivan Agnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Kelly Sullivan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
East Hartford, CT 06118
- Reassigned Medicare billing, Connecticut enrollment
- 78 clinicians in this Medicare group
Hartford, CT 06106
- Reassigned Medicare billing, Connecticut enrollment
- 417 clinicians in this Medicare group
North Billerica, MA 01862
- Reassigned Medicare billing, Massachusetts enrollment
- 9 clinicians in this Medicare group
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 06066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 1427549088. It was assigned to this individual provider in the NPPES registry on May 19, 2018.
Where is Kelly Sullivan located?
Kelly Sullivan practices at 428 Hartford Tpke Ste 207, Vernon, CT 06066. The listed phone number is (860) 872-5426.
What is Kelly Sullivan's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Kelly Sullivan enrolled in Medicare?
Yes. Kelly Sullivan is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kelly Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Sullivan reassigns Medicare benefits to 3 organizations: Intercommunity, Inc. (East Hartford, CT), Connecticut Gi PLLC (Hartford, CT) and Joshi Medical Services, PC (North Billerica, MA). 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 Kelly 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 Kelly Sullivan was last updated on May 19, 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.
# Kelly Elizabeth Sullivan, AGNP-C · NPI 1427549088
Primary Care physician in Vernon, Connecticut. Individual provider, active in the CMS NPPES registry since May 19, 2018.
## Identity
- **NPI:** 1427549088 (Entity type: Individual)
- **Enumerated:** May 19, 2018
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** 390200000X (Connecticut)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 428 HARTFORD TPKE STE 207, Vernon, CT 06066-4841
- **Phone:** (860) 872-5426
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Intercommunity, Inc. (NPI 1073548533, East Hartford, CT); Connecticut Gi PLLC (NPI 1023124625, Hartford, CT); Joshi Medical Services, PC (NPI 1588698591, North Billerica, MA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 19, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1427549088) · Data from the CMS NPPES public registry.