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BENJAMIN JACOB SULLIVAN PA-C
NPI 1710684758
Physician Assistant - Medical in Iowa City, IA

Active since February 09, 2023PECOS Enrolled
200 HAWKINS DR, IOWA CITY, IA 52242(319) 356-2233(319) 356-0533 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 10, 2025, Feb 10, 2025, Apr 24, 2024 and 3 more (6 updates tracked since 2023).

About Benjamin Jacob Sullivan Pa-c NPPES

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

BENJAMIN JACOB SULLIVAN PA-C (NPI 1710684758) is an individual medical provider in Iowa City, Iowa, licensed in Iowa (129254) and active in the NPI registry since February 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710684758
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameBENJAMIN JACOB SULLIVANCredential: PA-C
Location Address200 HAWKINS DRIowa City, IA 52242-1009
Mailing Address200 Hawkins DrIowa City, IA 52242-1009 · (319) 356-2233 · Fax (319) 356-0533
Phone(319) 356-2233
Fax(319) 356-0533
Sole ProprietorNo
Enumeration DateFebruary 9, 2023
Last NPPES UpdateMarch 10, 20256 updates tracked since enumeration
NPPES CertifiedMarch 10, 2025
✔ NPI 1710684758 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 IA · 129254
200 HAWKINS DR, Iowa City, IA 52242
Open in Google Maps ↗

Other Identifiers 1

MedicaidQ081975TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Benjamin Jacob Sullivan Pa-c 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.

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.

SANGIL LEE M.D.
Emergency Medicine
200 HAWKINS DR
IOWA CITY, IA 52242
Johnson County (319) 356-2233
RAMI G. EL ABIAD M.D.
Internal Medicine (Gastroenterology)
200 HAWKINS DR
IOWA CITY, IA 52242
Johnson County (319) 356-4901
GRERK SUTAMTEWAGUL MD
Internal Medicine (Hematology & Oncology)
200 HAWKINS DR, DEPT OF INTERNAL MEDICINE
IOWA CITY, IA 52242
Johnson County (319) 356-1616
DR. KALEB TANNER VEIT D.O.
Internal Medicine (Critical Care Medicine)
200 HAWKINS DR
IOWA CITY, IA 52242
Johnson County (319) 356-2320
OMAR JABER M.D
Chronic Disease Hospital
200 HAWKINS DR
IOWA CITY, IA 52242
Johnson County (319) 471-8958
JENNIFER MANCUSO MS, CGC
Genetic Counselor, MS
200 HAWKINS DR, 31663 PFP
IOWA CITY, IA 52242
Johnson County (319) 384-7983
ASHLEY KAISER M.D.
Obstetrics & Gynecology
200 HAWKINS DR, DEPT OF OBGYN
IOWA CITY, IA 52242
Johnson County (319) 356-2294
MRS. NANCY JANE MILLICE
Health Educator
200 HAWKINS DR, 0733 JPP
IOWA CITY, IA 52242
Johnson County (319) 356-3825

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 Benjamin Sullivan's NPI number?

The NPI number for Benjamin Sullivan is 1710684758. It was assigned to this individual provider in the NPPES registry on February 9, 2023.

Where is Benjamin Sullivan located?

Benjamin Sullivan practices at 200 Hawkins Dr, Iowa City, IA 52242. The listed phone number is (319) 356-2233.

What is Benjamin Sullivan's specialty?

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

Is Benjamin Sullivan enrolled in Medicare?

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

What insurance does Benjamin Sullivan accept?

Health plans from Medica list Benjamin 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.

When was this NPI record last updated?

The NPPES record for Benjamin Sullivan was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.