Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ELEXA SULLIVAN PA
NPI 1760359400
Physician Assistant in Lebanon, TN

Q: What is Elexa Sullivan's NPI number?

The NPI number for Elexa Sullivan is 1760359400. It was assigned to this individual provider in the NPPES registry on October 18, 2025.

Q: What is Elexa Sullivan's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Elexa Sullivan was last updated on July 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days 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.

Active since October 18, 2025PECOS EnrolledAccepts Medicare Assignment

702 S CUMBERLAND ST, LEBANON, TN 37087(615) 444-2121(615) 547-6474 Get Directions Write a Review

NPPES record last updated: July 24, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 24, 2026, Nov 20, 2025 (2 updates tracked since 2025).

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About Elexa Sullivan Pa NPPES

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

ELEXA SULLIVAN PA (NPI 1760359400) is an individual physician assistant in Lebanon, Tennessee, licensed in Tennessee (6839) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS and is a graduate of Lincoln Mem Univ, Debusk Col Of Osteopathic Med (2025).

NPPES Registry Identity

NPI1760359400

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameELEXA SULLIVANCredential: PA

Location Address702 S CUMBERLAND STLebanon, TN 37087-4110

Mailing Address702 S Cumberland StLebanon, TN 37087-4110 · (615) 444-2121 · Fax (615) 547-6474

Phone(615) 444-2121

Fax(615) 547-6474

Sole ProprietorNo

Medical School CMSLincoln Mem Univ, Debusk Col Of Osteopathic MedGraduated 2025

Enumeration DateOctober 18, 2025

Last NPPES UpdateJuly 24, 20262 updates tracked since enumeration

NPPES CertifiedJuly 24, 2026

✔ NPI 1760359400 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 TN · 6839

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.

702 S CUMBERLAND ST, Lebanon, TN 37087

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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 and accepts Medicare assignment

Elexa Sullivan Pa 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 ID2365913225

PECOS Enrollment IDI20260602002483

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 37087 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. CYRUS GRANT NABAVI PA

Physician Assistant