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THERESA E SULLIVAN D.O. , M.P.H
NPI 1447539655
Hospitalist in Mount Pleasant, WI

Active since August 05, 2011PECOS EnrolledAccepts Medicare Assignment
13250 WASHINGTON AVE, MOUNT PLEASANT, WI 53177(262) 799-8700 Get Directions Write a Review

NPPES record last updated: October 16, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 16, 2023, May 18, 2022, Nov 24, 2021 and 2 more (5 updates tracked since 2018).

About Theresa E Sullivan D.o. , M.p.h NPPES

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

THERESA E SULLIVAN D.O. , M.P.H (NPI 1447539655) is an individual hospitalist provider in Mount Pleasant, Wisconsin, licensed in Wisconsin (62926) and active in the NPI registry since August 2011. She is enrolled in Medicare PECOS, is affiliated with Aurora Lakeland Medical Center, and maintains a secondary practice location in Grafton.

NPPES Registry Identity

NPI1447539655
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NameTHERESA E SULLIVANCredential: D.O. , M.P.H
Location Address13250 WASHINGTON AVEMount Pleasant, WI 53177-1516
Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (414) 649-6000
Phone(262) 799-8700
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateAugust 5, 2011
Last NPPES UpdateOctober 16, 20235 updates tracked since enumeration
NPPES CertifiedOctober 16, 2023
✔ NPI 1447539655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in WI · 62926
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 125060039 (IL), 62926 (WI)
13250 WASHINGTON AVE, Mount Pleasant, WI 53177
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Secondary Practice Location 1

Location 1975 Port Washington RdGrafton, WI 53024 · Phone (262) 329-1000 · Fax (262) 329-1001

Other Identifiers 2

Medicaid100040719WI
Other032.0109679VT · State License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theresa E Sullivan D.o. , M.p.h 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 ID3072837160
PECOS Enrollment IDI20150120002107
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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
202 services97 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
153 services79 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
126 services116 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
106 services98 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
15 services14 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Aurora Lakeland Medical Center

Acute Care Hospitals · Elkhorn, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520102
LocationW3985 County Road NnElkhorn, WI 53121 · Walworth County
Emergency services Birthing friendly

Aurora St Lukes Medical Center

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520138
Location2900 W Oklahoma AveMilwaukee, WI 53215 · Milwaukee County
Emergency services Birthing friendly

Aurora Medical Center Kenosha

Acute Care Hospitals · Kenosha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520189
Location10400 75th StKenosha, WI 53142 · Kenosha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53177 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers13 claims13 services$17.53 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers25 claims25 services$90.82 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

ALEXIS MARIE VENTURA DNP, CRNA
Nurse Anesthetist, Certified Registered
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (262) 857-5000
JACK CONOR NEYLON
Registered Nurse
13250 WASHINGTON AVE
MT PLEASANT, WI 53177
Racine County (262) 799-8700
DR. ADRIAN KENNETH STULL M.D.
Emergency Medicine
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (262) 799-8700
JAMES M WALTENBERGER MD
Surgery
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (888) 720-2012
DR. DONNA J HEMPHILL MD
Obstetrics & Gynecology
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (888) 720-2012
MARGARET ANN RYNKIEWICZ
Physician Assistant
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (262) 799-8700
MR. JEFFREY THOMAS VAUGHAN KROEGER CRNA
Nurse Anesthetist, Certified Registered
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (262) 799-8700
MR. EVAN JACOB CLARK MD
Emergency Medicine
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (262) 799-8200

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 Theresa Sullivan's NPI number?

The NPI number for Theresa Sullivan is 1447539655. It was assigned to this individual provider in the NPPES registry on August 5, 2011.

Where is Theresa Sullivan located?

Theresa Sullivan practices at 13250 Washington Ave, Mount Pleasant, WI 53177. The listed phone number is (262) 799-8700.

What is Theresa Sullivan's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Theresa Sullivan enrolled in Medicare?

Yes. Theresa 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.

What insurance does Theresa Sullivan accept?

Health plans from Aspirus Health Plan and CareSource (Common Ground Healthcare) list Theresa Sullivan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Theresa Sullivan affiliated with any hospitals?

According to CMS data, Theresa Sullivan is affiliated with Aurora Lakeland Medical Center, Aurora St Lukes Medical Center and Aurora Medical Center Kenosha.

When was this NPI record last updated?

The NPPES record for Theresa Sullivan was last updated on October 16, 2023. 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.