RAYMOND JAMES SULLIVAN (MD) – Anesthesiology Physician, NPI 1093790065

RAYMOND JAMES SULLIVAN (MD) is a healthcare provider. based in Edgewood, Kentucky. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. They hold a License No. 26391 (KY). The NPI Number for RAYMOND JAMES SULLIVAN (MD) is 1093790065

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
RAYMOND JAMES SULLIVAN (MD)
NPI
1093790065
Phone
(859) 341-7246
Address
20 MEDICAL VILLAGE DR
Enumeration Date
13 December 2005
Last Update Date
20 February 2008

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Secondary Phone
8592125200
Graduation Year
1985 (41 years ago)
PAC ID
4082609821
Group Practice PAC ID
1254245137
Professional Enrollment ID
I20040420000122
Address ID
KY410424824FL4900XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

756 ANESTHESIOLOGY in KY

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Provider Addresses for RAYMOND JAMES SULLIVAN (MD)

  • 20, Medical Village Drive, Edgewood, Kenton County, Kentucky, 41017, United States

    STE 258

    EDGEWOOD, KY 41017

    Phone: (859) 341-7246

    Fax: (859) 341-7867

    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: 2004-04-20

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
I20040420000122IAnesthesiologyKYTBD

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
00142Anesthesia for lens surgery4242$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1919$0
View full utilization report →

Insurance plans in this area (ZIP 41017)

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Provider's Procedures

RAYMOND JAMES SULLIVAN (MD) performs procedures in ANESTHESIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYKY00790Anesthesia for procedure in upper abdomen including use of an endoscope2222
ANESTHESIOLOGYKY76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle3131

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: 1254245137View full group profile
NameSpecialtyState
-NC
-KY
A N E S T H E S I O L O G YMI
A N E S T H E S I O L O G YOH
A N E S T H E S I O L O G YIL
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)WA
-PA
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)OH

Reviews

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Frequently asked questions

Is there an official ID for RAYMOND JAMES SULLIVAN (MD) in U.S. healthcare records?
The official identifier for RAYMOND JAMES SULLIVAN (MD) is NPI 1093790065.
Would RAYMOND JAMES SULLIVAN (MD) appear as active to a payer?
You can treat RAYMOND JAMES SULLIVAN (MD) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe RAYMOND JAMES SULLIVAN (MD)'s focus?
For RAYMOND JAMES SULLIVAN (MD), the primary taxonomy reads as Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Is RAYMOND JAMES SULLIVAN (MD) associated with Edgewood?
Public fields place RAYMOND JAMES SULLIVAN (MD) around Edgewood, Kentucky. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for RAYMOND JAMES SULLIVAN (MD) is noted as December 13, 2005 where the registry provides it.

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