Michael Durgin Sullivan, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

200101144 Issued in NC

Practice address

1814 Glen Meade Rd
Wilmington, NC 28403-6023

Phone

(910) 254-3544

Fax

(910) 254-3543

NPI assigned

Oct 19, 2006

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 5

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

Dermatology

Education

Duke University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Dermatology and Skin Cancer Surgery PAGroup PAC ID 0042290934, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msul@cdscs.emadirect.md

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 Dermatology and Skin Cancer Surgery PA

  • Dermatology Physician
  • Wilmington, NC
  • NPI 1942428982
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1215019351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036023",
            "telephone_number": "910-254-3544",
            "fax_number": "910-254-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036023",
            "telephone_number": "910-254-3544",
            "fax_number": "910-254-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHAEL",
        "middle_name": "DURGIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "200101144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "136VC",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD ID",
            "identifier": "P00154798",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST ID",
            "identifier": "D4250",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136VC",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "200101144",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Zachary Suits, LCSWA
• Emily Sullivan
• Jaclyn Sullivan, MA COUNSELING
• Jesse Danielle Sullivan, MSW, LCSWA
• Laura Rose Sullivan
• Riley Sullivan
• Tristan Colby Sullivan
• Michele Renee Sulwer, DPT
• David Lee Summerfield, RN,NP-C,CNOR,RNFA
• Berta Jane Summers, PHD

• Dermatology Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.