CHARLI ELIZABETH SULLIVAN (PA) – Physician Assistant, NPI 1003522657
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,232 PHYSICIAN ASSISTANT in FL
Provider Addresses for CHARLI ELIZABETH SULLIVAN (PA)
88 BLUE STREAM WAY APT 11302
INLET BEACH, FL 324618633
Phone: (601) 765-7277
Type: Mailing
15415 PANAMA CITY BEACH PKWY
PANAMA CITY BEACH, FL 324135409
Phone: (850) 588-3589
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $205.
Total Amount is formed as General ($205) + Research ($0) + Ownership ($0) = $205.
Last reported payment date: 2024-06-24 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($173).
Total Amount
$205
General + Research + Ownership
Payments
6
Total payment records
General Amount
$205
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $173 |
| Novo Nordisk Inc | $32 |
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: 2023-03-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230324001142 | I | Physician Assistant | FL | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 220 | 39 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 110 | 110 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 105 | 76 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 92 | 39 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 72 | 72 | $0 |
Insurance plans in this area (ZIP 32461)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | GA | |
| Nurse Practitioner | FL | |
| Family Practice | GA | |
| Nurse Practitioner | AL | |
| Internal Medicine | FL | |
| Physician Assistant | GA | |
| - | FL | |
| - | KY | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | AZ |
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