Caroline Elena Sulich-Moore, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704361059 Issued in MI

Practice address

11900 E 12 Mile Rd Ste 201
Warren, MI 48093-3490

Phone

(586) 574-2800

NPI assigned

Sep 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Center for Dermatology and Pathology PLLCGroup PAC ID 0446330492, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: csulichmoore@mwcd.emadirect.md

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

• Midwest Center for Dermatology & Pathology, PLLC

  • Dermatopathology Physician
  • Clinton Township, MI
  • NPI 1003095084
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1467238246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "692 W LINCOLN ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091964",
            "telephone_number": "248-914-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 E 12 MILE RD STE 201",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933490",
            "telephone_number": "586-574-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULICH-MOORE",
        "first_name": "CAROLINE",
        "middle_name": "ELENA",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704361059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Banumathy Subramanian, MD
• Hannah Marie Suciu, OTR/L
• Sudad Louis MD PLLC
• Sudhir Lingnurkar MD PLC
• Robin Jade Mahinay Suelan
• Deanna Sullivan
• Elizabeth Ann Sullivan, OTRL
• Thomas S. Sullivan, M.S., R.PH., BCNSP
• Sultan Home Care LLC (sul)
• Marilynn Sultana-Gallick, M.D.

• Family Nurse Practitioner in Warren, MI
• Providers in Warren, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.