MARK MONTOGOMERY SULLIVAN PAC, MPAS NPI 1700023348

Physician Assistant in Murray, UT

NPI 1700023348 Individual Male Physician Assistant PECOS Enrolled

About MARK SULLIVAN

Mark Sullivan is a primary care provider established in Murray, Utah and his medical specialization is physician assistant. The NPI number of Mark Sullivan is 1700023348 and was assigned on January 2009. The practitioner's primary taxonomy code is 363A00000X with license number 7131889-1206 (UT). The provider is registered as an individual and his NPI record was last updated 12 years ago.

A primary care provider (PCP) like Mark Montogomery Sullivan Pac, Mpas sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Mark Sullivan is enrolled in PECOS and is eligible to order or refer healthcare 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.

Mark Sullivan is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1700023348

Provider Name MARK MONTOGOMERY SULLIVAN PAC, MPAS
Provider Location Address5121 COTTONWOOD ST SUITE 320 MURRAY, UT 84107
Provider Mailing Address2609 OAK CREEK DR SANDY, UT 84093
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date01-20-2009
Last Update Date01-25-2010


Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.7131889-1206
License StateUT
Taxonomy DescriptionA 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.

Business Address

MARK MONTOGOMERY SULLIVAN PAC, MPAS
5121 COTTONWOOD ST
SUITE 320
MURRAY, UT
ZIP 84107
Phone: (801) 507-3380

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Mailing Address

MARK MONTOGOMERY SULLIVAN PAC, MPAS
2609 OAK CREEK DR
SANDY, UT
ZIP 84093
Phone: (801) 244-2834



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1639284516 JACOB S PUGSLEY M.D.
Individual
Anesthesiology5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-7000
1356459010DR. MATTHEW JAMES PARSONS MD
Individual
Emergency Medicine5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 269-2500
1679667265 MICHAEL DEAN AKAGI RPH
Individual
Pharmacist5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-3030
1881788859MRS. BRENDA ROSSETTI COTA / L
Individual
Occupational Therapy Assistant5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-7571
1215059266 JENNIFER MARIE GIRTEN O.T.
Individual
Occupational Therapist5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-3967
1720286255 JARED R. LAKE M.D.
Individual
Anesthesiology5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-5248
1629260880IHC HEALTH SERVICES INC
Organization
Clinic/Center (Multi-Specialty)5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 442-1400
1356537062 TYLER BURNETT
Individual
Anesthesiology (Pediatric Anesthesiology)5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-5248
1437345493MRS. MELISSA LYNN HOFFMAN OCCUPATIONAL THERAPI
Individual
Occupational Therapist5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-2001
1881874345 DEBORAH MILLET CCC-SLP
Individual
Speech-Language Pathologist5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-1249
1770763112 MEGAN ANNE GARDNER M.A., CCC-SLP
Individual
Speech-Language Pathologist5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-1247
1679756373DR. ERICA S CHENOWETH PH.D.
Individual
Psychologist5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-1260
1891951091DR. J MANUEL ZARANDONA M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)5121 COTTONWOOD ST INTERMOUNTAIN MEDICAL CENTER DEPT. OF PATHOLOGY
MURRAY, UT 84107
(801) 507-7970
1104074103MR. JOSHUA AARON FERGUSON APRN-BC
Individual
Nurse Practitioner5121 COTTONWOOD ST RESPIRATORY INTENSIVE CARE UNIT
MURRAY, UT 84107
(801) 507-6422
1942459458 MARGARET MEAD THORNTON LCSW
Individual
Social Worker (Clinical)5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-6699
1649429887 AMY L STOWE ACNP-BC
Individual
Nurse Practitioner (Acute Care)5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-6475
1558507517 MARY E.G. RANDLE NP
Individual
Registered Nurse (Gerontology)5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-4248
1013155357 PATRICIA HARTLEY-CLANTON APRN
Individual
Nurse Practitioner5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-7000
1992028658MRS. EMILY LOTT SMITH MS, CCC-SLP
Individual
Speech-Language Pathologist5121 COTTONWOOD ST
MURRAY, UT 84107
(801) 507-1247
1710200373IHC HEALTH SERVICES INC
Organization
Clinic/Center (Multi-Specialty)5121 COTTONWOOD ST 130
MURRAY, UT 84107
(801) 507-7070

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.