DR. SHANNON MARIE SULLIVAN M.D.
NPI 1972998680
Family Medicine in Menasha, WI

Q: What is Shannon Sullivan's NPI number?

The NPI number for Shannon Sullivan is 1972998680. It was assigned to this individual provider in the NPPES registry on March 31, 2015.

Q: What is Shannon 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 Shannon Sullivan was last updated on September 13, 2018. 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.

Active since March 31, 2015PECOS EnrolledAccepts Medicare Assignment

2005 MIDWAY RD, MENASHA, WI 54952(920) 832-8500(920) 993-2919 Get Directions Write a Review

NPPES record last updated: September 13, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Shannon Marie Sullivan M.d. NPPES

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

DR. SHANNON MARIE SULLIVAN M.D. (NPI 1972998680) is an individual family medicine provider in Menasha, Wisconsin, licensed in Wisconsin (66251) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and maintains a secondary practice location in Milwaukee.

NPPES Registry Identity

NPI1972998680

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SHANNON MARIE SULLIVANCredential: M.D.

Location Address2005 MIDWAY RDMenasha, WI 54952

Mailing Address122 E College AveAppleton, WI 54911-5794 · (920) 996-3264 · Fax (920) 830-5910

Phone(920) 832-8500

Fax(920) 993-2919

Sole ProprietorNo

Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2015

Enumeration DateMarch 31, 2015

Last NPPES UpdateSeptember 13, 2018

✔ NPI 1972998680 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 66251

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.

2005 MIDWAY RD, Menasha, WI 54952

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Secondary Practice Location 1

Location 11121 E North AveMilwaukee, WI 53212-3515 · Phone (414) 267-6502 · Fax (414) 267-3892

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.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

Dr. Shannon Marie Sullivan M.d. 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 ID8820365976

PECOS Enrollment IDI20181002000755

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.

Areas of Expertise CMS Part B claims 12

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

166 services94 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

151 services85 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

98 services65 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

79 services61 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

64 services40 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

63 services63 patients

Screening mammography 77067

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

36 services36 patients

Screening 3d breast mammography 77063

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

34 services34 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

20 services19 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

20 services19 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

19 services15 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520045

Location130 2nd StNeenah, WI 54956 · Winnebago County

Emergency services Birthing friendly

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520160

Location1818 N Meade StAppleton, WI 54911 · Outagamie County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54952 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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 14

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

NATHAN C GRUNWALD MD

Family Medicine