Dr Lisa C Sullivan, MD - Medicare Pediatrics in Milwaukie, OR

Dr Lisa C Sullivan, MD is a medicare enrolled "Pediatrics" physician in Milwaukie, Oregon. Her current practice location is 4950 Se Roethe Rd, Milwaukie, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 722-6858.

Dr Lisa C Sullivan is licensed to practice in Oregon (license number MD24619) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1841380375.

Contact Information

Dr Lisa C Sullivan, MD
4950 Se Roethe Rd,
Milwaukie, OR 97267-5746
(503) 722-6858
(503) 722-6826



Physician's Profile

Full NameDr Lisa C Sullivan
GenderFemale
SpecialityPediatrics
Location4950 Se Roethe Rd, Milwaukie, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1841380375
  • Provider Enumeration Date: 10/13/2006
  • Last Update Date: 06/27/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 1658463245
  • Enrollment ID: I20070828000310

Medical Identifiers

Medical identifiers for Dr Lisa C Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1841380375NPI-NPPES
096511MedicaidOR
240558MedicaidOR
22959MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics MD24619 (Oregon)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Lisa C Sullivan allows following entities to bill medicare on her behalf.
Entity NameMultnomah County
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609914787
PECOS PAC ID: 6608771787
Enrollment ID: O20031203000025

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Entity NameClackamas County
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841443587
PECOS PAC ID: 9537065560
Enrollment ID: O20031210000827

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lisa C Sullivan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Lisa C Sullivan, MD
421 Sw Oak St, Ste 210,
Portland, OR 97204-1817

Ph: (503) 988-7468
Dr Lisa C Sullivan, MD
4950 Se Roethe Rd,
Milwaukie, OR 97267-5746

Ph: (503) 722-6858

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Read more News

› Verified 9 days ago


Pediatrics Doctors in Milwaukie, OR

Donald W. Fortlage,
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 10202 Se 32nd Ave, Suite 201, Milwaukie, OR 97222
Phone: 503-653-0770    Fax: 503-653-0844

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