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JOSHUA JOSEPH SUMISLAWSKI MD
NPI 1528455680
Surgery in Chapel Hill, NC

Active since April 16, 2015PECOS EnrolledAccepts Medicare Assignment
97.12/100
CMS Quality Rating
101 MANNING DR, CHAPEL HILL, NC 27514(984) 974-1000 Get Directions Write a Review

NPPES record last updated: September 16, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 16, 2024, Aug 1, 2024, Aug 9, 2023 (3 updates tracked since 2023).

About Joshua Joseph Sumislawski Md NPPES

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

JOSHUA JOSEPH SUMISLAWSKI MD (NPI 1528455680) is an individual surgery provider in Chapel Hill, North Carolina, licensed in North Carolina (2024-02520) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Unc Hospitals, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1528455680
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJOSHUA JOSEPH SUMISLAWSKICredential: MD
Location Address101 MANNING DRChapel Hill, NC 27514-4220
Mailing Address4008 Burnett-womack Building, Campus Box 7228Chapel Hill, NC 27599-7228
Phone(984) 974-1000
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateApril 16, 2015
Last NPPES UpdateSeptember 16, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2024
✔ NPI 1528455680 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in NC · 2024-02520
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedSurgery · Surgical Critical CareTaxonomy 2086S0102X · License 2024-02520 (NC)
Also ListedSurgery · Trauma SurgeryTaxonomy 2086S0127X · License 2024-02520 (NC)
101 MANNING DR, Chapel Hill, NC 27514
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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Joshua Joseph Sumislawski Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103139936
PECOS Enrollment IDI20250131000260
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
78 services45 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
53 services53 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
36 services36 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
18 services12 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
17 services15 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Unc Hospitals

Acute Care Hospitals · Chapel Hill, NC
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number340061
Location101 Manning DriveChapel Hill, NC 27514 · Orange County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27514 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.12/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.64
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TERESA MARY ANDERSON PHARM.D.
Pharmacist (Pharmacotherapy)
101 MANNING DR, CB 7600
CHAPEL HILL, NC 27514
Orange County (919) 966-2457
DR. KAMAKSHI V RAO PHARMD, BCOP
Pharmacist (Oncology)
101 MANNING DR, CB#7600, UNC HOSPITAL
CHAPEL HILL, NC 27514
Orange County (919) 966-1434
MS. MELODY ANN WATRAL MSN, RN, CPNP
Nurse Practitioner
101 MANNING DR
CHAPEL HILL, NC 27514
Orange County (919) 966-8809
MORGAN TREPTE PHARM.D.
Pharmacist (Oncology)
101 MANNING DR, CB 7600
CHAPEL HILL, NC 27514
Orange County (984) 974-8346
TREVOR STEPHEN BARLOWE
Student in an Organized Health Care Education/Training Program
101 MANNING DR
CHAPEL HILL, NC 27514
Orange County (984) 974-1000
KRISTIN M HEAD RN
Registered Nurse
101 MANNING DR
CHAPEL HILL, NC 27514
Orange County (984) 974-5421
KALYNN ANNE NORTHAM PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
101 MANNING DR
CHAPEL HILL, NC 27514
Orange County (984) 974-3765
KEVIN IVAN MORALES DEL MORAL
Internal Medicine (Cardiovascular Disease)
101 MANNING DR
CHAPEL HILL, NC 27514
Orange County (984) 974-1000

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 Joshua Sumislawski's NPI number?

The NPI number for Joshua Sumislawski is 1528455680. It was assigned to this individual provider in the NPPES registry on April 16, 2015.

Where is Joshua Sumislawski located?

Joshua Sumislawski practices at 101 Manning Dr, Chapel Hill, NC 27514. The listed phone number is (984) 974-1000.

What is Joshua Sumislawski's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Joshua Sumislawski enrolled in Medicare?

Yes. Joshua Sumislawski is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Joshua Sumislawski accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list Joshua Sumislawski 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.

Is Joshua Sumislawski affiliated with any hospitals?

According to CMS data, Joshua Sumislawski is affiliated with Unc Hospitals.

When was this NPI record last updated?

The NPPES record for Joshua Sumislawski was last updated on September 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.