DR. JEREMY TYSON SULLIVAN (M.D.) – Internal Medicine Physician, NPI 1053379644

DR. JEREMY TYSON SULLIVAN (M.D.) is a healthcare provider. based in Carmel, Indiana. specializing in Internal Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 35131 (TN). The NPI Number for DR. JEREMY TYSON SULLIVAN (M.D.) is 1053379644

Main info

Male
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. JEREMY TYSON SULLIVAN (M.D.)
NPI
1053379644
Phone
(615) 478-3720
Address
10601 WINTERWOOD
Enumeration Date
3 May 2006
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
7653746044
Graduation Year
1998 (28 years ago)
PAC ID
8729143615
Group Practice PAC ID
7618285057
Professional Enrollment ID
I20090706000135
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for DR. JEREMY TYSON SULLIVAN (M.D.)

  • 10601, Winterwood, Carmel, Hamilton County, Indiana, 46032, United States

    CARMEL, IN 460328258

    Phone: (615) 478-3720

    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: 2009-07-06

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
I20090706000135IInternal MedicineINTBD

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes5642$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 46032)

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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: 7618285057View full group profile

Reviews

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Frequently asked questions

What NPI should I save for DR. JEREMY TYSON SULLIVAN (M.D.)?
Save NPI 1053379644 if you need a stable reference for DR. JEREMY TYSON SULLIVAN (M.D.).
Is DR. JEREMY TYSON SULLIVAN (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does DR. JEREMY TYSON SULLIVAN (M.D.) list a primary specialty?
If you are matching referrals, note Internal Medicine Physician for DR. JEREMY TYSON SULLIVAN (M.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. JEREMY TYSON SULLIVAN (M.D.)?
The page summarizes Carmel, Indiana for DR. JEREMY TYSON SULLIVAN (M.D.); expand the address list for detail.
What if Carmel, Indiana seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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