Toby Michael Sullivan, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2005-00836 Issued in NC

Practice address

3333 Silas Creek Pkwy
Emergency Department
Winston-Salem, NC 27103-3013

Phone

(336) 765-3928

NPI assigned

Dec 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Texas Tech University Health Science Center School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.09 of 100Reported as group

Quality

84.49

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

86.5 of 100Reported as group

Quality

84.11

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: tsullivan126257@direct.novanthealth.org

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.

• Carolina Medicorp Enterprises, LLC

  dba Novant Health GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1760950646
  Medicare reassignment Care Compare group NPD
• Kernersville Emergency Group, PLLC

  • Emergency Medicine Physician
  • Kernersville, NC
  • NPI 1750852034
  Medicare reassignment NPD
• Piedmont Triad Physicians, PLLC

  • Emergency Medicine Physician
  • Thomasville, NC
  • NPI 1295206464
  Medicare reassignment NPD
• Tanglewood Park Physicians, PLLC

  • Emergency Medicine Physician
  • Clemmons, NC
  • NPI 1093286379
  Medicare reassignment NPD
• Yadkin Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Elkin, NC
  • NPI 1417443771
  Medicare reassignment NPD
• Forsyth Emergency Services, P.a.

  • Emergency Medicine Physician
  • Winston Salem, NC
  • NPI 1649256983
  Medicare reassignment
• Carolina Medicorp Enterprises, LLC

  dba Novant Health GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Asheville, NC
  • NPI 1235014796
  NPD
• Emergency Medicine Physicians of Cortland County, PLLC

  • Emergency Medicine Physician
  • Cortland, NY
  • NPI 1609816024
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1134104086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-765-3928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2452 Fairlawn Ct",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063884",
            "country_code": "US",
            "telephone_number": "336-443-9910",
            "fax_number": "336-443-9909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TOBY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2005-00836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900996",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Laurel Sullivan, MD
• Lindsay Tempel Sullivan, ACNP
• Marie Elizabeth Sullivan, MD
• Thomas Patrick Sullivan, M.D.
• Tiyika Janaye Sullivan, NURSE PRACTITIONER
• William C. Sullivan, MD
• Lisa E Summerfield, C.R.N.A
• Sarah Lynne Summerford, PA-C
• Carli Allen Summers, MSN, APRN, NNP-BC
• Erik C Summers, MD

• Emergency Medicine Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.