JACK SULLIVAN DPT
NPI 1790388981
Physical Therapist in Glendale, AZ

Active since November 19, 2020Accepts Medicare Assignment
18561 N 59TH AVE, GLENDALE, AZ 85308(602) 313-4089(623) 322-0664 Get Directions Write a Review

NPPES record last updated: February 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 6, 2025, Dec 6, 2024, Nov 19, 2020 (3 updates tracked since 2020).

About Jack Sullivan Dpt NPPES

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

JACK SULLIVAN DPT (NPI 1790388981) is an individual physical therapist in Glendale, Arizona, licensed in Arizona (LPT-32921) and active in the NPI registry since November 2020. He maintains a secondary practice location in Seneca and is a graduate of Other (2020).

NPPES Registry Identity

NPI1790388981
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameJACK SULLIVANCredential: DPT
Location Address18561 N 59TH AVEGlendale, AZ 85308-1256
Mailing Address2001 Butterfield Rd Ste 1600Downers Grove, IL 60515-1211
Fax(623) 322-0664
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateNovember 19, 2020
Last NPPES UpdateFebruary 6, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2025
NPI 1790388981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License Licensed in AZ · LPT-32921
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
18561 N 59TH AVE, Glendale, AZ 85308

Secondary Practice Location 1

Location 112023 N Radio Station Rd Ste ASeneca, SC 29678-1143 · Phone (864) 985-0770

Accepted 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

Jack Sullivan Dpt 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 ID6800207671
PECOS Enrollment IDI20241213002565

Areas of Expertise CMS Part B claims 2

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.

Therapy procedure using functional activities 97530
A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.
93 services16 patients
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110
This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
53 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85308 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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

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

Physical Therapist
18561 N 59TH AVE
GLENDALE, AZ 85308

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 Jack Sullivan's NPI number?

The NPI number for Jack Sullivan is 1790388981. It was assigned to this individual provider in the NPPES registry on November 19, 2020.

Where is Jack Sullivan located?

Jack Sullivan practices at 18561 N 59th Ave, Glendale, AZ 85308. The listed phone number is (602) 313-4089.

What is Jack Sullivan's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Jack Sullivan enrolled in Medicare?

Yes. Jack 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 Jack Sullivan accept?

Health plans from Ambetter from Arizona Complete Health list Jack 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 Jack Sullivan was last updated on February 6, 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.