Individual provider Active NPI

Michael L Sukaloski Jr., RD

  • Registered Dietitian
  • Biddeford, ME
National Provider Identifier
1093525925
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI2148 Issued in ME
Practice address
119 South St
Biddeford, ME 04005-2311
Phone
(207) 303-2399
NPI assigned
Jan 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI2148 ME Primary

Addresses

Primary practice location

119 South St
Biddeford, ME 04005-2311

Mailing address

119 South St
Biddeford, ME 04005-2311
Phone (207) 303-2399

Other practice location 1

41 Donald B Dean Dr Ste A
South Portland, ME 04106-3252
Phone (207) 661-6064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250811001390 ME Practitioner - Registered Dietitian Or Nutrition Professional 6305344219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

41 Donald B Dean Dr
Suite a
South Portland, ME 04106-3252
Phone (207) 661-6064

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI2148MEMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jun 5, 2025 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Jun 5, 2025 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

41 Donald B Dean Dr
#A
South Portland, ME 04106
Phone (207) 661-6064

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1093525925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SOUTH ST",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040052311",
            "telephone_number": "207-303-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 SOUTH ST",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040052311",
            "telephone_number": "207-303-2399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Donald B Dean Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "South Portland",
            "state": "ME",
            "postal_code": "041063252",
            "country_code": "US",
            "telephone_number": "207-661-6064",
            "fax_number": "207-253-6073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUKALOSKI",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI2148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.