JACK SULLIVAN DPT
NPI 1790388981
Physical Therapist in Glendale, AZ
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
Specialties & Licenses
- 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.
Secondary Practice Location 1
Accepted 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
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.
Medicare Billing Reassignments
3Medicare enrollment records show Jack Sullivan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Peoria, AZ 85381
- Reassigned Medicare billing, Arizona enrollment
- 273 clinicians in this Medicare group
Phoenix, AZ 85022
- Reassigned Medicare billing, Arizona enrollment
- 436 clinicians in this Medicare group
Horsham, PA 19044
- Reassigned Medicare billing, Pennsylvania enrollment
- 136 clinicians in this Medicare group
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 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.
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.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.
Which organizations bill Medicare for Jack Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Sullivan reassigns Medicare benefits to 3 organizations: Arizona Luna Care Physical Therapy, LLC (Peoria, AZ), Ati Holdings Of Arizona, LLC (Phoenix, AZ) and Pennsylvania Luna Care Physical Therapy LLC (Horsham, PA). 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 Jack Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jack Sullivan accept?
Health plans from Ambetter Health and 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 20 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.