TERRENCE R SULLIVAN MD
NPI 1447244785
Urology in Los Gatos, CA
NPI Status: Active since September 01, 2005
Contact Information
16450 MATILIJA DR
LOS GATOS, CA
ZIP 95030
Phone: (408) 590-3159
- Individual
- Male
- Urology
- PECOS Enrolled
- Medicare Quality Reporting
About TERRENCE SULLIVAN
This page provides the complete NPI Profile along with additional information for Terrence Sullivan, a provider established in Los Gatos, California with a medical specialization in Urology. The healthcare provider is registered in the NPI registry with number 1447244785 assigned on September 2005. The practitioner's primary taxonomy code is 208800000X with license number G25099 (CA). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1447244785
- Provider Name
- TERRENCE R SULLIVAN MD
- Other Name
- TERRY SULLIVAN
- Other Name Type
- Professional Name (2)
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 16450 MATILIJA DR LOS GATOS, CA 95030
- Location Phone
- (408) 590-3159
- Mailing Address
- 16450 MATILIJA DR LOS GATOS, CA 95030
- Mailing Phone
- (408) 590-3159
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 09-01-2005
- Last Update Date
- 10-24-2023
- Code Navigator
Location Map
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
Urology
- Taxonomy Code
- 208800000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G25099
- License State
- CA
- Taxonomy Description
- A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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.
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 |
|---|---|---|---|
| P00061715 | OTHER (01) | RAILROAD MEDICARE |
Medicare Participation & PECOS Enrollment Status
Terrence 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
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, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Manual urinalysis test with examination using microscope, automated
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 224 times for 152 patientsThis 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 18 times for 15 patientsA manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.
This service was performed 194 times for 140 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 95030 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $156.67
- Minimum New Patient Price $70.37
- Maximum New Patient Price $206.04
- Average New Patient Copayment $39.16
- Minimum New Patient Copayment $17.59
- Maximum New Patient Copayment $51.51
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $86.56
- Minimum Established Patient Price $23.96
- Maximum Established Patient Price $169.6
- Average Established Patient Copayment $21.64
- Minimum Established Patient Copayment $5.99
- Maximum Established Patient Copayment $42.4
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| Engagement of Patients, Family, and Caregivers in Developing a Plan of Care | Yes | N/A |
| Engage patients, family, and caregivers in developing a plan of care and prioritizing their goals for action, documented in the electronic health record (EHR) technology. | ||
| Pneumococcal Vaccination Status for Older Adults | 83% | 452 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Practice Improvements for Bilateral Exchange of Patient Information | Yes | N/A |
| Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes. | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
| Unhealthy alcohol use | Yes | N/A |
| Unhealthy alcohol use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including screening and brief counseling (refer to NQF #2152) for patients with co-occurring conditions of behavioral or mental health conditions. | ||
| Use of certified EHR to capture patient reported outcomes | Yes | N/A |
| In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review. | ||
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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 1447244785, we treat the final digit (5) 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 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 75 is 80. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1447244785, enumerated as an "individual" on September 01, 2005.
The provider is located at 16450 MATILIJA DR LOS GATOS, CA 95030 and the phone number is (408) 590-3159.
Urology with taxonomy code 208800000X.
The provider might be accepting Accepts: Railroad Medicare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
