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MARK MONTOGOMERY SULLIVAN PAC, MPAS
NPI 1700023348
Physician Assistant in Murray, UT

Active since January 20, 2009PECOS EnrolledAccepts Medicare Assignment
5121 COTTONWOOD ST, SUITE 320, MURRAY, UT 84107(801) 507-3380 Get Directions Write a Review

NPPES record last updated: January 25, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mark Montogomery Sullivan Pac, Mpas NPPES

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

MARK MONTOGOMERY SULLIVAN PAC, MPAS (NPI 1700023348) is an individual physician assistant in Murray, Utah, licensed in Utah (7131889-1206) and active in the NPI registry since January 2009. He is enrolled in Medicare PECOS, is affiliated with Intermountain Medical Center, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1700023348
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMARK MONTOGOMERY SULLIVANCredential: PAC, MPAS
Location Address5121 COTTONWOOD ST, SUITE 320Murray, UT 84107-5701
Mailing Address2609 Oak Creek DrSandy, UT 84093-6522 · (801) 244-2834
Phone(801) 507-3380
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateJanuary 20, 2009
Last NPPES UpdateJanuary 25, 2010
✔ NPI 1700023348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in UT · 7131889-1206
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.
5121 COTTONWOOD ST, Murray, UT 84107
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.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

Mark Montogomery Sullivan Pac, Mpas 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 ID1951593631
PECOS Enrollment IDI20101013000674
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.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
19 services19 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
13 services13 patients
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.
12 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Intermountain Medical Center

Acute Care Hospitals · Murray, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460010
Location5121 South Cottonwood StreetMurray, UT 84107 · Salt Lake County
Emergency services Birthing friendly

Riverton Hospital

Acute Care Hospitals · Riverton, UT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460058
Location3741 West 12600 SouthRiverton, UT 84065 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84107 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

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.

PATRICIA HARTLEY-CLANTON APRN
Nurse Practitioner
5121 COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-7000
BRENDA EVERETT PHARM.D.
Pharmacist
5121 COTTONWOOD ST, OUTPATIENT PHARMACY
MURRAY, UT 84107
Salt Lake County (801) 507-3030
CODY REBECCA GOLD P.T.A.
Physical Therapy Assistant
5121 COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-7000
IHC HEALTH SERVICES, INC.
General Acute Care Hospital
5121 COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-7000
JENETT GREEN PTA
Physical Therapy Assistant
5121 COTTONWOOD ST, BOX 577000
MURRAY, UT 84107
Salt Lake County (801) 507-7000
PETER FREDRICK CROSSNO MD
Internal Medicine (Critical Care Medicine)
5121 COTTONWOOD ST, INTERMOUNTAIN MEDICAL CENTER RICU
MURRAY, UT 84107
Salt Lake County (801) 507-5492
MR. JOSHUA AARON FERGUSON APRN-BC
Nurse Practitioner
5121 COTTONWOOD ST, RESPIRATORY INTENSIVE CARE UNIT
MURRAY, UT 84107
Salt Lake County (801) 507-6422
ALEXANDER PAUL CONNER PTA
Physical Therapy Assistant
5121 COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-1254

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 Mark Sullivan's NPI number?

The NPI number for Mark Sullivan is 1700023348. It was assigned to this individual provider in the NPPES registry on January 20, 2009.

Where is Mark Sullivan located?

Mark Sullivan practices at 5121 Cottonwood St Suite 320, Murray, UT 84107. The listed phone number is (801) 507-3380.

What is Mark Sullivan's specialty?

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

Is Mark Sullivan enrolled in Medicare?

Yes. Mark 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 Mark Sullivan accept?

Health plans from Select Health list Mark 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 Mark Sullivan affiliated with any hospitals?

According to CMS data, Mark Sullivan is affiliated with Intermountain Medical Center and Riverton Hospital.

When was this NPI record last updated?

The NPPES record for Mark Sullivan was last updated on January 25, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.