KELSI SULLIVAN (PA-C) – Physician Assistant, NPI 1669450144
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,091 PHYSICIAN ASSISTANT in MA
Provider Addresses for KELSI SULLIVAN (PA-C)
1 ORTHOPEDIC DR
2ND FLOOR
PEABODY, MA 019601668
Phone: (978) 818-6350
Fax: (978) 818-6355
Type: Mailing
201 Broad St
Stamford, CT 069012004
Phone: (781) 254-8837
Type: Location
1045 Elm St Ste 204
Manchester, NH 031011844
Phone: (888) 760-4266
Type: Location
15333 N Pima Rd Ste 305
Scottsdale, AZ 852602717
Phone: (888) 760-4266
Type: Location
6200 Stoneridge Mall Rd Fl 3
Pleasanton, CA 945883242
Phone: (888) 760-4266
Type: Location
9005 Overlook Blvd
Brentwood, TN 370275269
Phone: (888) 760-4266
Type: Location
325 N Saint Paul St Ste 3100
Dallas, TX 752013923
Phone: (888) 760-4266
Type: Location
1800 Pembrook Dr Ste 300
Orlando, FL 328106378
Phone: (888) 760-4266
Type: Location
24 MORGAN CT
RYE, NH 038702033
Phone: (781) 254-8837
Type: Mailing
244 N CONGRESS AVE # 2A
BOYNTON BEACH, FL 334264212
Phone: (888) 760-4266
Fax: (203) 774-4636
Type: Location
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: 2025-10-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 13 Medicare enrollment records; no due dates published yet.
Enrollment records
13
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 |
|---|---|---|---|---|
| I20040511000187 | I | Physician Assistant | MA | TBD |
| I20230525000832 | I | Physician Assistant | CA | TBD |
| I20230718002306 | I | Physician Assistant | FL | TBD |
| I20231019001698 | I | Physician Assistant | TN | TBD |
| I20231030002800 | I | Physician Assistant | NH | TBD |
| I20231107004043 | I | Physician Assistant | AZ | TBD |
| I20240131002131 | I | Physician Assistant | TX | TBD |
| I20240307000237 | I | Physician Assistant | VA | TBD |
| I20240717004067 | I | Physician Assistant | MD | TBD |
| I20240801001538 | I | Physician Assistant | CT | TBD |
| I20240822004099 | I | Physician Assistant | DC | TBD |
| I20240831000208 | I | Physician Assistant | MI | TBD |
| I20251021002550 | I | Physician Assistant | NV | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 01960)
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