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SUMMIT PLASTIC SURGERY & DERMATOLOGY, PLLC
NPI 1437749330
Dermatology in Wilmington, NC

Active since January 25, 2021CLIA Certified · 3 labs
1717 SHIPYARD BLVD STE 103, WILMINGTON, NC 28403(910) 794-5355 Get Directions Write a Review

NPPES record last updated: June 4, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 4, 2021, Jan 25, 2021 (2 updates tracked since 2021).

About Summit Plastic Surgery & Dermatology, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMIT PLASTIC SURGERY & DERMATOLOGY, PLLC (NPI 1437749330) is a healthcare organization registered as a dermatology in Wilmington, North Carolina and active in the NPI registry since January 2021. The organization holds 3 active CLIA laboratory certificates and lists Jeffrey S Fromowitz, Authorized Group Official, as its authorized official.

NPPES Registry Identity

NPI1437749330
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSUMMIT PLASTIC SURGERY & DERMATOLOGY, PLLC
Location Address1717 SHIPYARD BLVD STE 103Wilmington, NC 28403-8023
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000 · Fax (561) 431-2821
Phone(910) 794-5355
Organization SubpartNo
Authorized OfficialJeffrey S FromowitzAuthorized Group Official · (561) 314-2000
Enumeration DateJanuary 25, 2021
Last NPPES UpdateJune 4, 20212 updates tracked since enumeration
NPPES CertifiedJune 4, 2021
✔ NPI 1437749330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1717 SHIPYARD BLVD STE 103, Wilmington, NC 28403
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Summit Plastic Surgery & Dermatology, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Summit Plastic Surgery & Dermatology, PLLC, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Maura Jones
Dermatology
NPI 1114623139
1717 SHIPYARD BLVD STE 100
Wilmington, NC 28403
(910) 794-5355
✔ PECOS✔ Accepts Medicare0.1 mi
Lydia Shedlofsky, DO
Dermatology
NPI 1508367186
1717 SHIPYARD BLVD STE 100
Wilmington, NC 28403
(910) 794-5355
✔ PECOS✔ Accepts Medicare0.1 mi
Roger Sica, DO
Dermatology
NPI 1154578797
1717 SHIPYARD BLVD STE 100
Wilmington, NC 28403
(910) 794-5355
✔ PECOS✔ Accepts Medicare0.1 mi
Susan Sobel
Nurse Practitioner
NPI 1588908149
1717 SHIPYARD BLVD STE 100
Wilmington, NC 28403
(910) 794-5355
✔ PECOS✔ Accepts Medicare0.1 mi
Sara Varzari, CRNP
Nurse Practitioner
NPI 1437885399
1717 SHIPYARD BLVD STE 100
Wilmington, NC 28403
(910) 794-5355
✔ PECOS✔ Accepts Medicare0.1 mi
Edward Ricciardelli, MD
Plastic and Reconstructive Surgery
NPI 1073518064
1717 SHIPYARD BLVD SUITE 100
Wilmington, NC 28403
(910) 794-5355
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 34D1072196

Summit Plastic Surgery & Dermatology · Supply, NC
Active · expires Sep 22, 2027
CLIA Number34D1072196
Laboratory TypePhysician Office
Certificate Effective DateSeptember 23, 2025
Certificate Expiration DateSeptember 22, 2027
Laboratory DirectorRoger S. Sica
Laboratory Phone(910) 794-5355
Laboratory LocationSummit Plastic Surgery & Dermatology58 Physicians Drive NW, Suite 103, Supply, NC 28462
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 34D2135242

Summit Plastic Surgery & Dermatology · Hampstead, NC
Active · expires Jul 30, 2027
CLIA Number34D2135242
Laboratory TypePhysician Office
Certificate Effective DateJuly 31, 2025
Certificate Expiration DateJuly 30, 2027
Laboratory DirectorRoger S. Sica
Laboratory Phone(910) 794-5355
Laboratory LocationSummit Plastic Surgery & Dermatology14057 Highway 17, Suite 130, Hampstead, NC 28443
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 34D2043305

Summit Plastic Surgery & Dermatology · Wilmington, NC
Active · expires Dec 9, 2026
CLIA Number34D2043305
Laboratory TypePhysician Office
Certificate Effective DateDecember 10, 2024
Certificate Expiration DateDecember 9, 2026
Laboratory DirectorDr. Lydia B. Shedlofsky
Laboratory Phone(910) 794-5355
Laboratory LocationSummit Plastic Surgery & Dermatology1717 Shipyard Boulevard, Suite 100, Wilmington, NC 28403
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summit Plastic Surgery & Dermatology, PLLC's NPI number?

The NPI number for Summit Plastic Surgery & Dermatology, PLLC is 1437749330. It was assigned to this organization in the NPPES registry on January 25, 2021.

Where is Summit Plastic Surgery & Dermatology, PLLC located?

Summit Plastic Surgery & Dermatology, PLLC is located at 1717 Shipyard Blvd Ste 103, Wilmington, NC 28403. The listed phone number is (910) 794-5355.

What is Summit Plastic Surgery & Dermatology, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Summit Plastic Surgery & Dermatology, PLLC enrolled in Medicare?

Yes. Summit Plastic Surgery & Dermatology, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Summit Plastic Surgery & Dermatology, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Summit Plastic Surgery & Dermatology, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (3), Nurse Practitioner (2) and Plastic and Reconstructive Surgery (1). Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Summit Plastic Surgery & Dermatology, PLLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Summit Plastic Surgery & Dermatology, PLLC accept?

Health plans from Blue Cross and Blue Shield of NC list Summit Plastic Surgery & Dermatology, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Summit Plastic Surgery & Dermatology, PLLC was last updated on June 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.