JERRY SULLIVAN P.A.
NPI 1629062724
Physician Assistant - Medical in Tifton, GA

Q: What is Jerry Sullivan's NPI number?

The NPI number for Jerry Sullivan is 1629062724. It was assigned to this individual provider in the NPPES registry on September 2, 2005.

Q: What is Jerry Sullivan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Jerry Sullivan was last updated on April 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 September 02, 2005PECOS EnrolledAccepts Medicare Assignment

78.41/100

CMS Quality Rating

2225 US HIGHWAY 41 N, TIFTON, GA 31794(229) 391-4100 Get Directions Write a Review

NPPES record last updated: April 6, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Jerry Sullivan P.a. NPPES

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

JERRY SULLIVAN P.A. (NPI 1629062724) is an individual medical provider in Tifton, Georgia, licensed in Georgia (004285) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Tift Regional Medical Center, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1629062724

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameJERRY SULLIVANCredential: P.A.

Location Address2225 US HIGHWAY 41 NTifton, GA 31794-2749

Mailing Address907 18th St E Ste 400Tifton, GA 31794-3684 · (229) 391-4100

Phone(229) 391-4100

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateSeptember 2, 2005

Last NPPES UpdateApril 6, 2021

NPPES CertifiedApril 6, 2021

✔ NPI 1629062724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in GA · 004285

2225 US HIGHWAY 41 N, Tifton, GA 31794

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter 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

Jerry Sullivan P.a. 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 ID749269314

PECOS Enrollment IDI20040716000648

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 3

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.

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.

118 services109 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.

84 services77 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.

24 services24 patients

Hospital Affiliations CMS Care Compare 2

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

Tift Regional Medical Center

Acute Care Hospitals · Tifton, GA

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110095

Location901 E 18th StreetTifton, GA 31793 · Tift County

Emergency services Birthing friendly

Cook Medical Center A Campus Of Tift Reg Med Ctr

Acute Care Hospitals · Adel, GA

OwnershipProprietary

CMS Certification Number110101

Location260 Mj Taylor RoadAdel, GA 31620 · Cook County

Emergency services

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.

78.41/100

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

Scored as part of a group practice

Quality

58.68

Promoting Interoperability

100

Improvement Activities

Cost

66.15

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.

BENJAMIN R HESS MD

Family Medicine