MITCHELL SULLIVAN (MD) – Family Medicine Physician, NPI 1841292562

MITCHELL SULLIVAN (MD) is a healthcare provider. based in Lyndonville, Vermont. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 9367 (NH). The NPI Number for MITCHELL SULLIVAN (MD) is 1841292562

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
MITCHELL SULLIVAN (MD)
NPI
1841292562
Phone
(802) 748-9501
Address
PO BOX 83
Enumeration Date
12 August 2005
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8027489501
Graduation Year
1992 (34 years ago)
PAC ID
8022024108
Group Practice PAC ID
3678481405
Professional Enrollment ID
I20141121000566
Address ID
VT058514511LY195XXPKWY301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

355 FAMILY PRACTICE in VT

Provider Addresses for MITCHELL SULLIVAN (MD)

  • PO BOX 83

    LYNDONVILLE, VT 058510083

    Phone: (802) 748-9501

    Fax: (802) 748-3420

    Type: Mailing

  • 195 INDUSTRIAL PKWY

    LYNDONVILLE, VT 058514511

    Phone: (802) 748-9501

    Fax: (802) 748-3420

    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: 2014-11-21

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
I20141121000566IFamily PracticeVTTBD

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 05851)

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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: 3678481405View full group profile
NameSpecialtyState
-VT
Physician AssistantVT
Nurse PractitionerVT
Physician AssistantVT
Certified Nurse Midwife (Cnm)ME
Nurse PractitionerVT
O T O L A R Y N G O L O G YNH
Physical Therapist In Private PracticeVT
-VT
O B S T E T R I C S/ G Y N E C O L O G YNY

Reviews

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Frequently asked questions

What NPI should I save for MITCHELL SULLIVAN (MD)?
Save NPI 1841292562 if you need a stable reference for MITCHELL SULLIVAN (MD).
Is MITCHELL SULLIVAN (MD) active in the national directory?
MITCHELL SULLIVAN (MD)'s public NPI profile is in an active state.
Can you summarize MITCHELL SULLIVAN (MD)'s specialty in plain language?
Clinically, the directory lists MITCHELL SULLIVAN (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is MITCHELL SULLIVAN (MD)'s primary listing?
We display Lyndonville, Vermont because that is what the record indicates for MITCHELL SULLIVAN (MD).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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