RYAN SULLIVAN – Internal Medicine Physician, NPI 1124554571

RYAN SULLIVAN is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in INTERNAL MEDICINE. They hold a License No. DR.0066232 (CO). The NPI Number for RYAN SULLIVAN is 1124554571

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
RYAN SULLIVAN
NPI
1124554571
Phone
Not provided
Address
3400 SPRUCE ST
Enumeration Date
4 May 2017
Last Update Date
16 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3039510600
Graduation Year
2016 (10 years ago)
PAC ID
2769892355
Group Practice PAC ID
0749174753
Professional Enrollment ID
I20210610000454
Address ID
CO802281835LA274XXBLVD302
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

9,962 INTERNAL MEDICINE in PA

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Provider Addresses for RYAN SULLIVAN

  • Hospital of the University of Pennsylvania, 3400, Spruce Street, University City, Philadelphia, Philadelphia County, Pennsylvania, 19104, United States

    PHILADELPHIA, PA 191044238

    Phone:

    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)

CMS reports 2 Open Payments records for all available years, with a total value of $43.

Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.

Last reported payment date: 2024-09-19 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($43).

Total Amount

$43

General + Research + Ownership

Payments

2

Total payment records

General Amount

$43

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-19

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: 2021-06-10

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
I20210610000454IInternal MedicineCOTBD

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
99291Critical care, first 30-74 minutes10265$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes3621$0
99214Established patient office or other outpatient visit, 30-39 minutes1613$0
99204New patient office or other outpatient visit, 45-59 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 19104)

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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: 0749174753View full group profile
NameSpecialtyState
Internal Medicine, Pulmonary DiseaseCO
Pulmonary Disease, Critical Care (Intensivists)OH
Pulmonary DiseaseRI
Internal MedicineTN
Pulmonary DiseaseCO
Pulmonary DiseaseTN
Internal MedicinePA
Pulmonary DiseaseMA
Critical Care (Intensivists), Pulmonary Disease, Internal MedicineCO
Internal MedicineCO

Reviews

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Frequently asked questions

Can I cross-check RYAN SULLIVAN using NPI 1124554571?
NPI 1124554571 belongs to RYAN SULLIVAN; compare other details if you need extra assurance.
Would RYAN SULLIVAN appear as active to a payer?
You can treat RYAN SULLIVAN as active for directory purposes; confirm clinical privileges separately.
How would a patient describe RYAN SULLIVAN's focus?
For RYAN SULLIVAN, the primary taxonomy reads as Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Pennsylvania is RYAN SULLIVAN registered?
Use Philadelphia, Pennsylvania as the headline location for RYAN SULLIVAN here.
When was this NPI issued?
Enumeration for RYAN SULLIVAN is noted as May 4, 2017 where the registry provides it.

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