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KELLY ANN O'SULLIVAN M.D.
NPI 1750332474
Family Medicine - Geriatric Medicine in Vancouver, WA

Active since May 15, 2006PECOS EnrolledAccepts Medicare Assignment
89.01/100
CMS Quality Rating
750 SE FAIRWINDS LOOP, VANCOUVER, WA 98661(231) 838-2765 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kelly Ann O'sullivan M.d. NPPES

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

KELLY ANN O'SULLIVAN M.D. (NPI 1750332474) is an individual geriatric medicine provider in Vancouver, Washington, licensed in Michigan (4301081068) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Trinity Health Grand Haven Hospital, and maintains a secondary practice location in Vancouver.

NPPES Registry Identity

NPI1750332474
Entity TypeIndividualFemale
Primary Taxonomy207QG0300X
Provider Legal NameKELLY ANN O'SULLIVANCredential: M.D.
Location Address750 SE FAIRWINDS LOOPVancouver, WA 98661-8087
Mailing Address750 Se Fairwinds LoopVancouver, WA 98661-8087 · (231) 838-2765
Phone(231) 838-2765
Sole ProprietorNo
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 1997
Enumeration DateMay 15, 2006
Last NPPES UpdateMarch 17, 2018
✔ NPI 1750332474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
License✔ Licensed in MI · 4301081068
Definition
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
Also ListedFamily MedicineTaxonomy 207Q00000X · License MD60593078 (WA)
750 SE FAIRWINDS LOOP, Vancouver, WA 98661
Open in Google Maps ↗

Secondary Practice Location 1

Location 13400 Main StVancouver, WA 98663-2223 · Phone (360) 696-5232

Other Identifiers 3

OtherON19510MI · Medicare Group Ptan
OtherN19510003MI · Medicare Indiv Ptan
Medicaid5185089MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Ann O'sullivan M.d. 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 ID1052392305
PECOS Enrollment IDI20161118001829
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Kelly O'sullivan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Yakima Valley Memorial Physicians
122 mi
General Acute Care Hospital
2811 TIETON DRIVE
Yakima, WA 98902
  • Reassigned Medicare billing, Washington enrollment
  • 565 clinicians in this Medicare group
NPI 1306933940 (509) 575-8825
Noch Physician Billing Company LLC
1,798 mi
Family Medicine
1309 SHELDON RD
Grand Haven, MI 49417
  • Reassigned Medicare billing, Michigan enrollment
  • 28 clinicians in this Medicare group
NPI 1972550580 (616) 844-4528
Advantage Health/Saint Mary's Medical Group
1,820 mi
Urgent Care
3925 32ND AVE STE 500
Hudsonville, MI 49426
  • Reassigned Medicare billing, Michigan enrollment
  • 737 clinicians in this Medicare group
NPI 1538430533 (616) 685-1530
Saint Mary's Health Services
1,827 mi
Geriatric Medicine
200 JEFFERSON AVE SE
Grand Rapids, MI 49503
  • Reassigned Medicare billing, Michigan enrollment
  • 42 clinicians in this Medicare group
NPI 1063917425 (616) 776-0682

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
38 services26 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
31 services24 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
12 services12 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
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.

Trinity Health Grand Haven Hospital

Acute Care Hospitals · Grand Haven, MI
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number230174
Location1309 Sheldon RdGrand Haven, MI 49417 · Ottawa County
Emergency services

Yakima Valley Memorial

Acute Care Hospitals · Yakima, WA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500036
Location2811 Tieton DriveYakima, WA 98902 · Yakima County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98661 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
Most-billed visit code 99214
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.

89.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.05
Improvement Activities20
Cost74.56

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 Kelly O'sullivan's NPI number?

The NPI number for Kelly O'sullivan is 1750332474. It was assigned to this individual provider in the NPPES registry on May 15, 2006.

Where is Kelly O'sullivan located?

Kelly O'sullivan practices at 750 SE Fairwinds Loop, Vancouver, WA 98661. The listed phone number is (231) 838-2765.

What is Kelly O'sullivan's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Is Kelly O'sullivan enrolled in Medicare?

Yes. Kelly O'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.

Which organizations bill Medicare for Kelly O'sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly O'sullivan reassigns Medicare benefits to 4 organizations: Yakima Valley Memorial Physicians (Yakima, WA), Noch Physician Billing Company LLC (Grand Haven, MI), Advantage Health/Saint Mary's Medical Group (Hudsonville, MI) and Saint Mary's Health Services (Grand Rapids, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly O'sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly O'sullivan accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Kelly O'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 Kelly O'sullivan affiliated with any hospitals?

According to CMS data, Kelly O'sullivan is affiliated with Trinity Health Grand Haven Hospital and Yakima Valley Memorial.

When was this NPI record last updated?

The NPPES record for Kelly O'sullivan was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.