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JESSIE LYNN SULLIVAN NP
NPI 1790310589
Nurse Practitioner - Family in Grand Rapids, MI

Active since March 11, 2020PECOS EnrolledAccepts Medicare Assignment
3075 ORCHARD VISTA DR SE, GRAND RAPIDS, MI 49546(616) 301-8000 Get Directions Write a Review

NPPES record last updated: October 27, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: May 19, 2023, Mar 1, 2023, Mar 11, 2020 (3 updates tracked since 2020).

About Jessie Lynn Sullivan Np NPPES

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

JESSIE LYNN SULLIVAN NP (NPI 1790310589) is an individual family provider in Grand Rapids, Michigan, licensed in Michigan (4704301679) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, is affiliated with Mercy Health Saint Mary's, and maintains a secondary practice location in Grand Rapids.

NPPES Registry Identity

NPI1790310589
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJESSIE LYNN SULLIVANCredential: NP
Location Address3075 ORCHARD VISTA DR SEGrand Rapids, MI 49546-7069
Mailing Address17160 130th AveNunica, MI 49448-9450
Phone(616) 301-8000
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMarch 11, 2020
Last NPPES UpdateOctober 27, 20253 updates tracked since enumeration
NPPES CertifiedOctober 27, 2025
✔ NPI 1790310589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MI · 4704301679
Also ListedRegistered NurseTaxonomy 163W00000X · License 4704301679 (MI)
3075 ORCHARD VISTA DR SE, Grand Rapids, MI 49546
Open in Google Maps ↗

Secondary Practice Location 1

Location 1220 Cherry St SE # 1Grand Rapids, MI 49503-4608 · Phone (616) 685-5050 · Fax (616) 685-8962

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company.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

Jessie Lynn Sullivan Np 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 ID5698271179
PECOS Enrollment IDI20251002004729
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.

Hospital Affiliations CMS Care Compare

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

Mercy Health Saint Mary's

Acute Care Hospitals · Grand Rapids, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230059
Location200 Jefferson Avenue SEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49546 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

MORGAN ASHLEY ANN GUSTMAN
Technician (Personal Care Attendant)
3075 ORCHARD VISTA DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 301-8000
NICHOLAS MICHAEL WELCH
Technician (Personal Care Attendant)
3075 ORCHARD VISTA DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 726-1939
MICHELLE KIEU JOSLYN
Technician
3075 ORCHARD VISTA DR SE
GRAND RAPIDS, MI 49546
Kent County (269) 317-3309
KARLIYAH MURRAY
Technician (Attendant Care Provider)
3075 ORCHARD VISTA DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 301-8000
PEOPLECARE INC.
Home Health
3075 ORCHARD VISTA DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 975-6200
WENDY SCOTT
Behavior Analyst
3075 ORCHARD VISTA DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 726-1917
CHERYL DIANE BAZAN PT, DPT, CKTP
Physical Therapist
3075 ORCHARD VISTA DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 301-8000
HOPE NETWORK CORPORATE
Residential Treatment Facility, Physical Disabilities
3075 ORCHARD VISTA DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 248-5291

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 Jessie Sullivan's NPI number?

The NPI number for Jessie Sullivan is 1790310589. It was assigned to this individual provider in the NPPES registry on March 11, 2020.

Where is Jessie Sullivan located?

Jessie Sullivan practices at 3075 Orchard Vista Dr SE, Grand Rapids, MI 49546. The listed phone number is (616) 301-8000.

What is Jessie Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jessie Sullivan enrolled in Medicare?

Yes. Jessie 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 Jessie Sullivan accept?

Health plans from Oscar Insurance Company list Jessie 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 Jessie Sullivan affiliated with any hospitals?

According to CMS data, Jessie Sullivan is affiliated with Mercy Health Saint Mary's.

When was this NPI record last updated?

The NPPES record for Jessie Sullivan was last updated on October 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.