ANTHONY MICHAEL SULLIVAN (PSYD) – Clinical Psychologist, NPI 1245362615

ANTHONY MICHAEL SULLIVAN (PSYD) is a healthcare provider. based in Canon city, Colorado. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. 2778 (CO). The NPI Number for ANTHONY MICHAEL SULLIVAN (PSYD) is 1245362615

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
ANTHONY MICHAEL SULLIVAN (PSYD)
NPI
1245362615
Phone
(719) 275-2351
Address
3225 INDEPENDENCE RD
Enumeration Date
12 March 2007
Last Update Date
29 July 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8448437279
Graduation Year
2004 (22 years ago)
PAC ID
5496934218
Group Practice PAC ID
9537572490
Professional Enrollment ID
I20110126000517
Address ID
CO802461904DE720XXBLVD403
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness75
Years active:19State licenses:2Digital endpointsOther names

747 CLINICAL PSYCHOLOGIST in CO

Provider Addresses for ANTHONY MICHAEL SULLIVAN (PSYD)

  • 3225 INDEPENDENCE RD

    CANON CITY, CO 812129380

    Phone: (719) 275-2351

    Fax: (719) 269-9386

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110126000517IClinical PsychologistCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour22929$0
90791Psychiatric diagnostic evaluation1717$0
View full utilization report →

Insurance plans in this area (ZIP 81212)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537572490View full group profile
NameSpecialtyState
Marriage And Family TherapistCA
Clinical PsychologistCO
Clinical Social WorkerVA
Nurse PractitionerCO
P S Y C H I A T R YPA
Clinical Social WorkerCO
Clinical Social WorkerCO
Nurse PractitionerGA
Clinical Social WorkerCO
Nurse PractitionerTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for ANTHONY MICHAEL SULLIVAN (PSYD)?
ANTHONY MICHAEL SULLIVAN (PSYD) — NPI 1245362615 — is the standard way to identify this listing.
Does the file indicate ANTHONY MICHAEL SULLIVAN (PSYD) is practicing under active NPI?
Directory data currently reports ANTHONY MICHAEL SULLIVAN (PSYD) as active.
What healthcare role does ANTHONY MICHAEL SULLIVAN (PSYD) hold?
Scheduling teams often label ANTHONY MICHAEL SULLIVAN (PSYD) under Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where should I expect ANTHONY MICHAEL SULLIVAN (PSYD) on a map?
Expect Canon City, Colorado as a primary anchor for ANTHONY MICHAEL SULLIVAN (PSYD) unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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