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DR. LISA C. SULLIVAN M.D.
NPI 1841380375
Pediatrics in Milwaukie, OR

Active since October 13, 2006PECOS Enrolled
4950 SE ROETHE RD, MILWAUKIE, OR 97267(503) 722-6858(503) 722-6826 Get Directions Write a Review

NPPES record last updated: June 27, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Lisa C. Sullivan M.d. NPPES

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

DR. LISA C. SULLIVAN M.D. (NPI 1841380375) is an individual pediatrics provider in Milwaukie, Oregon, licensed in Oregon (MD24619) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841380375
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. LISA C. SULLIVANCredential: M.D.
Location Address4950 SE ROETHE RDMilwaukie, OR 97267-5746
Mailing Address421 Sw Oak St, Ste 210Portland, OR 97204-1817 · (503) 988-7468 · Fax (503) 988-7468
Phone(503) 722-6858
Fax(503) 722-6826
Sole ProprietorNo
Enumeration DateOctober 13, 2006
Last NPPES UpdateJune 27, 2019
✔ NPI 1841380375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in OR · MD24619
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
4950 SE ROETHE RD, Milwaukie, OR 97267
Open in Google Maps ↗

Other Identifiers 3

Medicaid096511OR
Medicaid22959OR
Medicaid240558OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans 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 (PECOS)

Dr. Lisa C. Sullivan M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

2

Medicare enrollment records show Lisa Sullivan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

County Of Clackamas Office Of County Auditor
1.9 mi
Mental Health (Including Community Mental Health Center)
6605 SE LAKE ROAD
Milwaukie, OR 97222
  • Reassigned Medicare billing, Oregon enrollment
  • 130 clinicians in this Medicare group
NPI 1245269315 (503) 655-8401
Multnomah County
6.7 mi
Public Health, State or Local
3653 SE 34TH AVE
Portland, OR 97202
  • Reassigned Medicare billing, Oregon enrollment
  • 215 clinicians in this Medicare group
NPI 1720126816 (503) 988-7462

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97267 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

Reported Quality Measures

Appropriate Treatment for Children with Upper Respiratory Infection (URI)
Percentage of children 3 months-18 years of age who were diagnosed with upper respiratory infection (URI) and were not dispensed an antibiotic prescription on or three days after the episode
96%238 patients
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
87%47 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
65%46 patients3/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
54%898 patients3/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
58%447 patients3/55-star benchmark: 96%
Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists
Percentage of children, age 0-20 years, who received a fluoride varnish application during the measurement period
34%1,551 patients
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
Patients nutrition: 22% · 1,102 patients
Patients physicalActivity: 29% · 1,102 patients
99%1,102 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 2

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

OUTSIDE IN
Clinic/Center (Federally Qualified Health Center (FQHC))
4950 SE ROETHE RD
MILWAUKIE, OR 97267
Clackamas County (503) 353-5847
CLAIRE ELISE DAVIS-THRAN RN
Registered Nurse (School)
4950 SE ROETHE RD
MILWAUKIE, OR 97267
Clackamas County (503) 353-6000

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 Lisa Sullivan's NPI number?

The NPI number for Lisa Sullivan is 1841380375. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Where is Lisa Sullivan located?

Lisa Sullivan practices at 4950 SE Roethe Rd, Milwaukie, OR 97267. The listed phone number is (503) 722-6858.

What is Lisa Sullivan's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Lisa Sullivan enrolled in Medicare?

Yes. Lisa Sullivan is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Lisa Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Sullivan reassigns Medicare benefits to 2 organizations: County Of Clackamas Office Of County Auditor (Milwaukie, OR) and Multnomah County (Portland, OR). 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 Lisa Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Sullivan accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Lisa 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 Lisa Sullivan was last updated on June 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.