ANDREW SULLIVAN DO
NPI 1912892001
Family Medicine in Pocatello, ID

Q: What is Andrew Sullivan's NPI number?

The NPI number for Andrew Sullivan is 1912892001. It was assigned to this individual provider in the NPPES registry on June 10, 2025.

Q: What is Andrew Sullivan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Andrew Sullivan was last updated on June 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since June 10, 2025PECOS Enrolled

465 MEMORIAL DR, POCATELLO, ID 83201(208) 232-7862 Get Directions Write a Review

NPPES record last updated: June 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Andrew Sullivan Do NPPES

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

ANDREW SULLIVAN DO (NPI 1912892001) is an individual family medicine provider in Pocatello, Idaho, licensed in Idaho (6071363) and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912892001

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameANDREW SULLIVANCredential: DO

Location Address465 MEMORIAL DRPocatello, ID 83201-4098

Mailing Address500 S 11th Ave Ste 400Pocatello, ID 83201-4880 · (208) 232-7862

Phone(208) 232-7862

Sole ProprietorYes

Enumeration DateJune 10, 2025

NPPES CertifiedJune 10, 2025

✔ NPI 1912892001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in ID · 6071363

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

465 MEMORIAL DR, Pocatello, ID 83201

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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 (PECOS)

Andrew Sullivan Do 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83201 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

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