IRIS SULLIVAN (MD) – Family Medicine Physician, NPI 1780640961

IRIS SULLIVAN (MD) is a healthcare provider. based in Fitchburg, Massachusetts. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. 156837 (MA). The NPI Number for IRIS SULLIVAN (MD) is 1780640961

Main info

Female
41 Years Of Experience
Accepts Medicare Assignment
Name
IRIS SULLIVAN (MD)
NPI
1780640961
Phone
(978) 809-0037
Address
64 WHALON STREET
Enumeration Date
25 April 2006
Last Update Date
9 July 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1985 (41 years ago)
PAC ID
2466494588
Professional Enrollment ID
I20090808000064
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

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Provider Addresses for IRIS SULLIVAN (MD)

  • 64, Whalon Street, Fitchburg, Worcester County, Massachusetts, 01420, United States

    FITCHBURG, MA 01420

    Phone: (978) 809-0037

    Fax: (978) 829-0048

    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: 2009-08-08

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
I20090808000064IFamily PracticeMATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01420)

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Reviews

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Frequently asked questions

Does IRIS SULLIVAN (MD) have a public NPI I can cite?
Public records show IRIS SULLIVAN (MD) under NPI 1780640961.
Quick check: is IRIS SULLIVAN (MD) active?
Public NPPES data shows IRIS SULLIVAN (MD) with an active NPI status right now.
How should patients interpret IRIS SULLIVAN (MD)'s specialty?
The extract shows Family Medicine Physician for IRIS SULLIVAN (MD). Clinical services aligned with this taxonomy classification.
Which community is linked to IRIS SULLIVAN (MD)?
IRIS SULLIVAN (MD) shows a connection to Fitchburg, Massachusetts in registry-derived data.
Can I export IRIS SULLIVAN (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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