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Deactivated NPI 1710087119 Deactivated / Inactive NPI Male Practitioner

Dr. Michael J Sullivan , MD

Internal Medicine • Ponca City, OK

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Michael Sullivan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 25, 2006
NPI Deactivation Date July 21, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Michael Sullivan, MD was a registered Internal Medicine practicing in Ponca City, OK. Throughout an active medical career spanning 16 years, Dr. Sullivan provided care at the practice location at 400 FAIRVIEW until profile deactivation on 2022-07-21.

Practice Location & Contact Primary Location

Practice Address

400 Fairview
Suite 19

Ponca City, OK 74602

Telephone 5807652496
Fax 5807620896
Associated Practice Facility / Clinic
🏢 Gary A Dorman Facility NPI 1023295839

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Ponca City, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 25.5 Yrs
State Avg: 26.0 Yrs
Regional Practice Density
4 Specialists

Practicing in Ponca City, OK (1179 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License OK 10274

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1265531610

Doctor of Medicine (M.D.)

Dr. Shrikrishna Vaidya , MD

Psychiatry & Neurology - Neurology

NPI 1295790459

Doctor of Medicine (M.D.)

Dr. Alzira Vaidya , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1356399927

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 21, 2022

Record deactivated on July 21, 2022

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 400 FAIRVIEW, SUITE 19, PONCA CITY, OK 74602 (Tel: 5807652496)

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Updated Business Mailing Address July 09, 2007

Registered at 400 FAIRVIEW, SUITE 19, PONCA CITY, OK 74602 (Tel: 5807652496)

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Provider Name / Credentials Updated July 09, 2007

Recorded as MICHAEL SULLIVAN, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Internal Medicine (License #10274 in OK)

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Initial NPI Registration & Enumeration September 25, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710087119
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 25, 2006
Last Update: July 09, 2007
Deactivation Date: July 21, 2022

Mailing Address

400 Fairview, Suite 19

Ponca City, OK 74602

Phone: 5807652496

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.