Active NPI
Mark Jeffrey Dufine, M.D.
- Emergency Medicine Physician
- Wilmington, NC
National Provider Identifier
1508820432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 38933
- Practice address
- 4402 Shipyard Blvd
Wilmington, NC 28403-6161 - Phone
- (910) 202-3363
- Fax
- (910) 791-9626
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 38933 | NC | |
| Emergency Medicine Physician | 207P00000X | 38933 | NC | Primary |
Addresses
Primary practice location
4402 Shipyard Blvd
Wilmington, NC 28403-6161
Mailing address
4402 Shipyard Blvd
Wilmington, NC 28403-6161
Phone (910) 202-3363
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 235110 | Medicaid | NC | |
| 8929274 | Medicaid | NC | |
| 29274 | Other | NC | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694649600000",
"number": "1508820432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4402 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036161",
"telephone_number": "910-202-3363",
"fax_number": "910-791-9626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4402 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036161",
"telephone_number": "910-202-3363",
"fax_number": "910-791-9626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFINE",
"first_name": "MARK",
"middle_name": "JEFFREY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2023-09-14",
"certification_date": "2023-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "38933",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "38933",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "235110",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8929274",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "29274",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.