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

Sonny Sullivan, PA-C

Individual provider Surgical Physician Assistant · NPI 1215610779

Sonny Sullivan, PA-C is a Physician Assistant in Clinton Twp, Michigan. Qualified in 2023, 3 years ago. Practices with Henry Ford Macomb Hospital Corporation, a 339-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

15855 19 Mile Rd
Clinton Twp, MI 48038-3504
Phone: (800) 532-2411
Show map & directions

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

Additional practice locations (2)

  • 400 Hobart St, Cadillac, MI 49601-2331 — (231) 876-7200
  • 1970 Ashland Dr, Mt Pleasant, MI 48858-1203 — (989) 854-2266

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601011968 (MI)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 5601011968 (MI)

Record details

NPI number1215610779
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 10, 2023
Last updated in NPPESApril 14, 2025
Certification dateApril 14, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Henry Ford Macomb Hospital Corporation — 339 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare