SCOTT SULLIVAN – Student in an Organized Health Care Education/Training Program, NPI 1932467123

SCOTT SULLIVAN is a healthcare provider. based in El paso, Texas. specializing in EMERGENCY MEDICINE. They hold a License No. S8254 (TX). The NPI Number for SCOTT SULLIVAN is 1932467123

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
SCOTT SULLIVAN
NPI
1932467123
Phone
(915) 532-2477
Address
4305 N MESA ST STE A
Enumeration Date
25 April 2012
Last Update Date
30 April 2026

Doctor Profile

Medical School Name
JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Secondary Phone
8306069111
Graduation Year
2012 (14 years ago)
PAC ID
9436551082
Group Practice PAC ID
8921446345
Professional Enrollment ID
I20210706001905
Address ID
TX781304194NE600XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness85
Years active:14State licenses:2Digital endpointsOther names

4,050 EMERGENCY MEDICINE in TX

Provider Addresses for SCOTT SULLIVAN

  • 4305 N MESA ST STE A

    EL PASO, TX 799021124

    Phone: (915) 532-2477

    Type: Location

  • 9040 FITZSIMMONS DR

    JOINT BASE LEWIS MCCHORD, WA 984311000

    Phone: (253) 968-2997

    Type: Mailing

  • 3551 ROGER BROOKE DR

    SAN ANTONIO, TX 782344504

    Phone: (210) 916-4141

    Type: Location

  • 4305 N Mesa St Ste A

    El Paso, TX 799021124

    Phone: (915) 532-2477

    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: 2025-11-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 4 Medicare enrollment records; no due dates published yet.

Enrollment records

4

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
I20210706001905IEmergency MedicineTXTBD
I20220616001450ICritical Care (Intensivists)MITBD
I20220618000426ICritical Care (Intensivists)MDTBD
I20251120001894ICritical Care (Intensivists)OHTBD

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 79902)

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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: 8921446345View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerVA
Critical Care (Intensivists)VA
Internal MedicineTX
Nurse PractitionerTX
Critical Care (Intensivists)TX
Nurse PractitionerTX
Critical Care (Intensivists), Pulmonary DiseaseFL

Reviews

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Frequently asked questions

Is SCOTT SULLIVAN listed with a National Provider Identifier?
Yes — SCOTT SULLIVAN has NPI 1932467123 on file in the registry.
Is there an active status for SCOTT SULLIVAN?
For scheduling context, SCOTT SULLIVAN is shown as active in the registry.
What clinical focus is listed for SCOTT SULLIVAN?
At a glance, SCOTT SULLIVAN is tied to Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
Is SCOTT SULLIVAN associated with El Paso?
Public fields place SCOTT SULLIVAN around El Paso, Texas. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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