Dominick Sam Defelice, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2023-00901 Issued in NC

Practice address

2523 Delaney Ave
Wilmington, NC 28403-6003

Phone

(910) 763-5522

Fax

(910) 763-0413

NPI assigned

May 3, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

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

Family PracticeAlso: Sports Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddefelice137829@direct.urmc.rochester.edu
• Direct secure messaging: ddefelice1335761@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.

• Novant Health Medical Group Coastal Region, LLC

  • Cardiovascular Disease Physician
  • Wilmington, NC
  • NPI 1649865791
  Medicare reassignment Care Compare group NPD
• NMG Health Services LLC

  • Maternal & Fetal Medicine Physician
  • Bolivia, NC
  • NPI 1558242495
  NPD
• Novant Health Medical Group Coastal Region, LLC

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1841877263

  Family Medicine

  NPD
• New Hanover Medical Group PA

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1992751374
  NPD (past)
• Novant Health Medical Group Coastal Region, LLC

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1255267423
  NPD (past)

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

• Novant Health New Hanover Regional Medical Center LLC

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1720577992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857",
            "telephone_number": "910-763-5522",
            "fax_number": "910-763-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 DELANEY AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036003",
            "telephone_number": "910-763-5522",
            "fax_number": "910-763-0413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Clinton Ave S",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146201448",
            "country_code": "US",
            "telephone_number": "585-279-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFELICE",
        "first_name": "DOMINICK",
        "middle_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-03",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-00901",
            "primary": true
        },
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "NY",
            "license": "309120",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "309120",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddefelice137829@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddefelice137829@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul Deconna, LCSW
• Beth A. Deeley, PA
• Shaun Michael Deese, M.D.
• Wilton O Deets III, CRNA
• Michael Defee
• Mary Margaret Deforest, OTR/L
• Abigail Jane Degaetano, OTD
• Michael Stephen Degon, M.D.
• Douglas Forrest Degroote, DDS
• Elizabeth Weaver Dehmer, M.D.

• Family Medicine Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.
• 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.