THEODORE K. SULLIVAN (O.D.) – Optometrist, NPI 1437153772

THEODORE K. SULLIVAN (O.D.) is a healthcare provider. based in Maplewood, Missouri. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. T02915 (MO). The NPI Number for THEODORE K. SULLIVAN (O.D.) is 1437153772

Main info

Male
36 Years Of Experience
Name
THEODORE K. SULLIVAN (O.D.)
NPI
1437153772
Phone
(314) 860-2020
Address
2021 MAPLEWOOD COMMONS DR
Enumeration Date
1 June 2005
Last Update Date
2 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2702972020
Graduation Year
1990 (36 years ago)
PAC ID
3971628017
Group Practice PAC ID
3971919226
Professional Enrollment ID
I20230103001252
Address ID
KY420017499PA467XXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:21State licenses:1Digital endpointsOther names

863 OPTOMETRY in MO

Provider Addresses for THEODORE K. SULLIVAN (O.D.)

  • 2021 MAPLEWOOD COMMONS DR

    MAPLEWOOD, MO 631431003

    Phone: (314) 860-2020

    Fax: (314) 860-2020

    Type: Mailing

  • 675 OLD BALLAS RD STE 220

    SAINT LOUIS, MO 631417083

    Phone: (314) 997-3937

    Type: Location

  • 15933 CLAYTON RD STE 201

    BALLWIN, MO 630112172

    Phone: (636) 200-4393

    Fax: (636) 527-0766

    Type: Mailing

  • 2021 Maplewood Commons Dr

    Maplewood, MO 631431003

    Phone: (314) 860-2020

    Fax: (314) 860-2020

    Type: Location

  • Clarkson Eyecare, 3071, Phoenix Center Drive, Phoenix Center II, Washington, Franklin County, Missouri, 63090, United States

    WASHINGTON, MO 630905690

    Phone: (636) 777-2345

    Fax: (636) 777-2115

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $267.

Total Amount is formed as General ($267) + Research ($0) + Ownership ($0) = $267.

Last reported payment date: 2024-09-27 • Largest payer in this snapshot: CooperVision Inc. ($225).

Total Amount

$267

General + Research + Ownership

Payments

9

Total payment records

General Amount

$267

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-27

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-01-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20100914000260IOptometryMOTBD
I20230103001252IOptometryKYTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes133116$0
92250Photography of the retina121120$0
92082Exam of visual field with intermediate testing114113$0
99204New patient office or other outpatient visit, 45-59 minutes7575$0
99213Established patient office or other outpatient visit, 20-29 minutes3126$0
View full utilization report →

Insurance plans in this area (ZIP 63143)

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Provider's Procedures

THEODORE K. SULLIVAN (O.D.) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYMO92012Eye and medical examination for diagnosis and treatment, established patient452299
OPTOMETRYMO92083Measurement of field of vision during daylight conditions8680
OPTOMETRYMO92134Diagnostic imaging of retina9383

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: 3971919226View full group profile
NameSpecialtyState
O P T O M E T R YMO
O P T O M E T R YIL
O P T O M E T R YMO

Reviews

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Frequently asked questions

What is the 10-digit NPI for THEODORE K. SULLIVAN (O.D.)?
THEODORE K. SULLIVAN (O.D.) — NPI 1437153772 — is the standard way to identify this listing.
Can I rely on THEODORE K. SULLIVAN (O.D.) being an active provider?
As of the registry snapshot, THEODORE K. SULLIVAN (O.D.) is marked active.
What taxonomy line describes THEODORE K. SULLIVAN (O.D.)?
For research purposes, treat THEODORE K. SULLIVAN (O.D.) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for THEODORE K. SULLIVAN (O.D.)?
THEODORE K. SULLIVAN (O.D.)'s geographic hint is Maplewood, Missouri in our summary view.
Is the information about THEODORE K. SULLIVAN (O.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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