JOHN MICHAEL SULLIVAN (PH.D.) – Psychologist, NPI 1538576764

JOHN MICHAEL SULLIVAN (PH.D.) is a healthcare provider. based in Toano, Virginia. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 0810004303 (VA). The NPI Number for JOHN MICHAEL SULLIVAN (PH.D.) is 1538576764

Main info

Male
Sole Proprietor
50 Years Of Experience
Accepts Medicare Assignment
Name
JOHN MICHAEL SULLIVAN (PH.D.)
NPI
1538576764
Phone
(757) 566-2238
Address
10145 SQUIRES WAY
Enumeration Date
21 July 2014
Last Update Date
21 July 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7574833404
Graduation Year
1976 (50 years ago)
PAC ID
9638446453
Group Practice PAC ID
1355314170
Professional Enrollment ID
I20170530000584
Address ID
VA233215699CH3101XRDXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

668 CLINICAL PSYCHOLOGIST in VA

Provider Addresses for JOHN MICHAEL SULLIVAN (PH.D.)

  • 10145 SQUIRES WAY

    TOANO, VA 231689541

    Phone: (757) 566-2238

    Type: Mailing

  • ONE OLD OYSTER POINT ROAD

    NEWPORT NEWS, VA 23602

    Phone: (757) 969-6848

    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: 2017-05-30

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
I20170530000584IClinical PsychologistVATBD

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 23168)

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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: 1355314170View full group profile
NameSpecialtyState
-VA
Mental Health CounselorVA
Clinical PsychologistVA
Clinical PsychologistVA
P S Y C H I A T R YVA
-VA
Clinical Social WorkerVA
Clinical Social WorkerNC
Marriage And Family TherapistPA
Clinical Social WorkerVA

Reviews

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Frequently asked questions

How do payers reference JOHN MICHAEL SULLIVAN (PH.D.)?
For JOHN MICHAEL SULLIVAN (PH.D.), use NPI 1538576764 as the unique 10-digit identifier.
Is there an active status for JOHN MICHAEL SULLIVAN (PH.D.)?
For scheduling context, JOHN MICHAEL SULLIVAN (PH.D.) is shown as active in the registry.
What clinical focus is listed for JOHN MICHAEL SULLIVAN (PH.D.)?
At a glance, JOHN MICHAEL SULLIVAN (PH.D.) is tied to Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JOHN MICHAEL SULLIVAN (PH.D.)?
Travel planning: use Toano, Virginia as the reference point for JOHN MICHAEL SULLIVAN (PH.D.), then confirm.
When was this NPI issued?
Enumeration for JOHN MICHAEL SULLIVAN (PH.D.) is noted as July 21, 2014 where the registry provides it.

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