DR. JOHN P SULLIVAN MD
NPI 1619977345
Ophthalmology in Jacksonville, FL

Q: What is John Sullivan's NPI number?

The NPI number for John Sullivan is 1619977345. It was assigned to this individual provider in the NPPES registry on July 22, 2005.

Q: What is John Sullivan's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for John Sullivan was last updated on April 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 22, 2005PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

7740 POINT MEADOWS DR, SUITE 3A, JACKSONVILLE, FL 32256(904) 527-3577(904) 527-3514 Get Directions Write a Review

NPPES record last updated: April 5, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. John P Sullivan Md NPPES

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

DR. JOHN P SULLIVAN MD (NPI 1619977345) is an individual ophthalmology provider in Jacksonville, Florida, licensed in Florida (ME0064370) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Creighton University School Of Medicine (1988).

NPPES Registry Identity

NPI1619977345

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameDR. JOHN P SULLIVANCredential: MD

Location Address7740 POINT MEADOWS DR, SUITE 3AJacksonville, FL 32256-9179

Mailing Address7740 Point Meadows Dr, Suite 3aJacksonville, FL 32256-9179 · (904) 527-3577 · Fax (904) 527-3514

Phone(904) 527-3577

Fax(904) 527-3514

Sole ProprietorNo

Medical School CMSCreighton University School Of MedicineGraduated 1988

Enumeration DateJuly 22, 2005

Last NPPES UpdateApril 5, 2017

✔ NPI 1619977345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in FL · ME0064370

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Also ListedOphthalmology · Retina SpecialistTaxonomy 207WX0107X · License ME64370 (FL), 37090 (GA)

7740 POINT MEADOWS DR, Jacksonville, FL 32256

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Other Identifiers 5

Medicaid373365300FL

Medicaid00578113AGA

Medicare ID-Type Unspecified18BDCPZGA

Medicare UPINF33855

Medicare ID-Type Unspecified188772FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and more.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

Dr. John P Sullivan Md 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 ID2961599741

PECOS Enrollment IDI20071025000324, I20101101000169

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 35

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.

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

7,504 services3,214 patients

Injection, faricimab-svoa, 0.1 mg J2777

Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.

6,960 services33 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

4,340 services863 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

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.

2,723 services1,913 patients

Compounded drug, not otherwise classified J7999

A compounded drug is a personalized medication created to meet unique patient needs. If you can't take standard drugs due to allergies or need a specific dosage not commercially available, a pharmacist can mix ingredients to make a drug specifically for you.

2,421 services517 patients

Injection, aflibercept, 1 mg J0178

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

2,366 services200 patients

Exam of retinal blood vessels using a special camera after injection of a dye 92235

This procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.

1,421 services1,285 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This 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.

1,199 services861 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

843 services740 patients

Injection, bevacizumab, 10 mg J9035

Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.

711 services149 patients

Injection, dexamethasone, intravitreal implant, 0.1 mg J7312

This procedure involves placing a tiny implant into your eye. This implant slowly releases a medication called dexamethasone, which helps to reduce inflammation and swelling in the eye, improving vision and comfort.

610 services37 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

588 services554 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

343 services336 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

315 services315 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

300 services300 patients

Removal of membrane of retina with removal of internal limiting membrane of retina 67042

This procedure involves the surgical removal of a thin layer, called the membrane, from the retina. It also includes the removal of the innermost layer of the retina, known as the internal limiting membrane. This can help improve vision.

194 services183 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

153 services153 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

131 services131 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

126 services26 patients

Destruction of leaking blood vessels of retina using laser 67228

This procedure involves using a laser to treat leaking blood vessels in the retina, the part of the eye responsible for vision. The laser seals off these vessels, preventing further leakage and helping to preserve sight.

108 services55 patients

Destruction of growth of retina using a laser 67210

This procedure involves using a precise laser to target and remove abnormal growths on the retina, the thin layer at the back of the eye. It's a safe and effective way to protect your vision and prevent further eye damage.

103 services86 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

102 services84 patients

Unclassified drugs J3490

Unclassified drugs are medications that don't fit into an existing category or class due to their unique properties or uses. They may be used for various conditions and their effects may differ widely. Always ask your healthcare provider for more information about these drugs.

97 services26 patients

Photocoagulation treatment to prevent detachment of retina 67145

Photocoagulation is a procedure used to treat retinal disorders. A special laser is directed at the retina to create small burns. These burns form scar tissue which helps to secure the retina to the eye's wall, preventing detachment and preserving vision.

80 services75 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

65 services63 patients

Destruction of eye fluid (vitreous) between lens and retina using a laser 67039

This procedure involves applying a laser to the eye's vitreous fluid, located between the lens and retina. The laser's heat destroys the vitreous, helping to treat specific eye conditions. The process is safe, typically painless, and can significantly improve vision quality.

47 services45 patients

Injection of drug or substance into membrane covering eyeball 67515

This procedure involves injecting medication into the membrane covering your eyeball, known as the conjunctiva. It's done to treat various eye conditions. A specialist will numb your eye first to minimize discomfort. You may experience temporary blurred vision afterwards.

31 services26 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

30 services28 patients

Repair of detached retina with drainage and removal of eye fluid between lens and retina 67108

This procedure addresses a detached retina, a serious eye condition. It involves draining fluid from between the lens and retina, allowing the retina to reattach. Then, the eye fluid is removed to prevent future detachments. It's a crucial step for vision restoration.

26 services26 patients

Repair of detached retina using a laser 67105

A laser repair for a detached retina is a non-invasive procedure. A laser beam is used to create small burns around the detached area, promoting scarring. This scarring helps reattach the retina to the back of the eye, restoring vision.

23 services23 patients

Exchange of prosthetic lens 66986

An exchange of a prosthetic lens involves replacing an artificial lens in your eye. This is often done if the current lens isn't functioning properly or causing discomfort. The procedure involves removing the old lens and inserting a new one, aiming to improve your vision.

22 services20 patients

Complex repair of detached retina and drainage of eye fluid between lens and retina 67113

This procedure involves reattaching your detached retina, a vital layer at the back of your eye. Simultaneously, excess fluid between your lens and retina is drained. This helps restore vision and prevent further eye damage.

19 services17 patients

Repair of detached retina by injection of air or gas 67110

This procedure involves injecting a bubble of air or gas into the eye to help reattach a detached retina. The bubble pushes against the retina, helping it reposition against the back wall of the eye, facilitating healing.

18 services18 patients

Removal of implant material from inside of eye 67121

This is a procedure to take out implant material from your eye that may have been placed during a previous surgery. It's typically done when the implant is causing discomfort or vision issues. The process is performed by a specialist under local or general anesthesia.

14 services14 patients

Destruction of vascular growth between retina and sclera by photocoagulation 67220

This procedure involves using a special light (photocoagulation) to treat abnormal blood vessel growth between the retina and sclera (back parts of your eye). It helps to prevent vision loss by stopping these vessels from bleeding or leaking fluid.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100088

Location800 Prudential DrJacksonville, FL 32207 · Duval County

Emergency services Birthing friendly

Flagler Hospital

Acute Care Hospitals · Saint Augustine, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100090

Location400 Health Park BlvdSaint Augustine, FL 32086 · St. Johns County

Emergency services Birthing friendly

Baptist Medical Center Beaches

Acute Care Hospitals · Jacksonville Beach, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100117

Location1350 13th Ave SJacksonville Beach, FL 32250 · Duval County

Emergency services Birthing friendly

Memorial Satilla Health

Acute Care Hospitals · Waycross, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110003

Location1900 Tebeau StreetWaycross, GA 31501 · Ware County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32256 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement

Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…

81%1,898 patients4/55-star benchmark: 100%

Age-Related Macular Degeneration (AMD): Dilated Macular Examination

Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…

99%1,898 patients4/55-star benchmark: 100%

Clinical Information Reconciliation

For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.

9%1,794 patients1/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred

39%104 patients2/55-star benchmark: 95%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

96%1,016 patients4/55-star benchmark: 100%

Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…

99%1,151 patients4/55-star benchmark: 100%

Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy

Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during…

99%1,157 patients4/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

97%12,709 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

92%5,065 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

1%3,629 patients1/55-star benchmark: 99%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…

1%5,802 patients1/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

47%1,860 patients3/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

30%2,576 patients2/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

9%1,610 patients1/55-star benchmark: 88%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 99% · 2,793 patients

Patients tobacco: 96% · 2,793 patients

51%168 patients3/55-star benchmark: 98%

Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation

Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months

94%899 patients4/55-star benchmark: 100%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

60%5,802 patients3/55-star benchmark: 100%

Request/Accept Summary of Care

21%24 patients1/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…

1%5,802 patients1/55-star benchmark: 77%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 3,629 patients

0%3,629 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 15

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

DR. WAYNE S. BARKER DDS, FACP

Dentist (Prosthodontics)

7740 POINT MEADOWS DR, STE 4
JACKSONVILLE, FL 32256

Duval County (904) 645-6457

PEJAI JO VALENTI PT

Physical Therapist

7740 POINT MEADOWS DR, SUITES 1&2
JACKSONVILLE, FL 32256

Duval County (904) 564-9594

DR. SHAWN AGEE M.D.

Ophthalmology (Retina Specialist)

7740 POINT MEADOWS DR, SUITE 3A
JACKSONVILLE, FL 32256

Duval County (904) 527-3577

MR. CHANDLER GARY KURTZ ATC, LAT

Specialist/Technologist (Athletic Trainer)

7740 POINT MEADOWS DR, SUITE 1 &2
JACKSONVILLE, FL 32256

Duval County (904) 564-9594

BAPTIST ENT SPECIALISTS INC

Otolaryngology

7740 POINT MEADOWS DR, SUITE 7
JACKSONVILLE, FL 32256

Duval County (904) 202-6400

JACKSONVILLE COMPLETE DENTISTRY PLLC

Dentist

7740 POINT MEADOWS DR, SUITES 4 & 5
JACKSONVILLE, FL 32256

Duval County (904) 645-6457

JACKSONVILLE ORTHOPAEDIC INSTITUTE INC

Orthopaedic Surgery

7740 POINT MEADOWS DR, SUITE 2
JACKSONVILLE, FL 32256

Duval County (904) 241-1204

DR. DEBORA G. DE FARIAS D.D.S, MS

Dentist (General Practice)

7740 POINT MEADOWS DR, SUITE 4
JACKSONVILLE, FL 32256

Duval County (904) 645-6457

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 John Sullivan's NPI number?

The NPI number for John Sullivan is 1619977345. It was assigned to this individual provider in the NPPES registry on July 22, 2005.

Where is John Sullivan located?

John Sullivan practices at 7740 Point Meadows Dr Suite 3A, Jacksonville, FL 32256. The listed phone number is (904) 527-3577.

What is John Sullivan's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is John Sullivan enrolled in Medicare?

Yes. John 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 John Sullivan accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter from Superior HealthPlan and 9 other insurers list John 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 John Sullivan affiliated with any hospitals?

According to CMS data, John Sullivan is affiliated with Baptist Health Medical Center - Jacksonville, Flagler Hospital, Baptist Medical Center Beaches and Memorial Satilla Health.

When was this NPI record last updated?

The NPPES record for John Sullivan was last updated on April 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.