Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Scot A Sullivan, MD

Individual provider Ophthalmology Physician · NPI 1164481230

Scot A Sullivan, MD is an Ophthalmology in Portland, Oregon. Graduated from University of Oklahoma College of Medicine in 1995, 31 years ago. Accepts Medicare assignment. Licensed in Oklahoma and Oregon.

Years since qualifying
31
Trained at
University of Oklahoma College of Medicine
Licensed in
OK, OR
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

10305 SW Park Way Ste 203
Portland, OR 97225-5033
Phone: (503) 223-8333
Fax: (503) 595-8160
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence MD21723 (OR)
Ophthalmology Physician Taxonomy 207W00000X · Licence 20157 (OK)

Record details

NPI number1164481230
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 18, 2006
Last updated in NPPESSeptember 17, 2021
Certification dateJuly 23, 2021
Mailing address10305 Sw Park Way Ste 203, Portland, OR 97225-5033

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPHTHALMOLOGY
Medical schoolUNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduated 1995 (31 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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