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JACQUELINE S SULLIVAN P.A.
NPI 1659829786
Physician Assistant in Bay Shore, NY

Active since September 19, 2016PECOS Enrolled
91.25/100
CMS Quality Rating
301 E MAIN ST, BAY SHORE, NY 11706(631) 894-5447 Get Directions Write a Review

NPPES record last updated: February 28, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 28, 2017, Oct 20, 2016, Sep 19, 2016 (3 updates tracked since 2016).

About Jacqueline S Sullivan P.a. NPPES

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

JACQUELINE S SULLIVAN P.A. (NPI 1659829786) is an individual physician assistant in Bay Shore, New York and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659829786
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJACQUELINE S SULLIVANCredential: P.A.
Location Address301 E MAIN STBay Shore, NY 11706-8408
Mailing Address301 East Main StreetBay Shore, NY 11706 · (631) 894-5447
Phone(631) 894-5447
Sole ProprietorNo
Enumeration DateSeptember 19, 2016
Last NPPES UpdateFebruary 28, 20173 updates tracked since enumeration
✔ NPI 1659829786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
301 E MAIN ST, Bay Shore, NY 11706
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline S Sullivan P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11706 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

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.

DR. EHAB SABRY HANNA M.D.
Hospitalist
301 E MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 968-3000
JENNA BANNON MS, RD, CDN
Dietitian, Registered
301 E MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 968-3593
DR. MEHUL PRAGANI MD
Anesthesiology
301 E MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 968-3000
ANDREA PASSANNANTE OT, OTR/L, CDIS
Occupational Therapist
301 E MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 968-3400
DR. STEPHEN CONSTANTINE LANDELL DNP, CRNA, RN
Nurse Anesthetist, Certified Registered
301 E MAIN ST
BAY SHORE, NY 11706
Suffolk County (516) 734-7000
PRIYANSHI CHANDIWALA
Physician Assistant (Surgical)
301 E MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 968-3000
DAVID VAUGHANS DO
Student in an Organized Health Care Education/Training Program
301 E MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 968-3000
DR. MATTHEW DAVID SCHWARTZ D.O.
Emergency Medicine
301 E MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 968-3314

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 Jacqueline Sullivan's NPI number?

The NPI number for Jacqueline Sullivan is 1659829786. It was assigned to this individual provider in the NPPES registry on September 19, 2016.

Where is Jacqueline Sullivan located?

Jacqueline Sullivan practices at 301 E Main St, Bay Shore, NY 11706. The listed phone number is (631) 894-5447.

What is Jacqueline Sullivan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jacqueline Sullivan enrolled in Medicare?

Yes. Jacqueline Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacqueline Sullivan was last updated on February 28, 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.