Michael Matthew Dominello, DO

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

5101019388 Issued in MI

Practice address

4100 John R
Detroit, MI 48201-2013

Phone

(800) 527-6266

Fax

(313) 576-9640

NPI assigned

May 24, 2010

Sex

Male

Sole proprietor

No

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Radiation Oncology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
• Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273
• Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277
• Harper University Hospital Hospital, Detroit, MI, CCN 230104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment Care Compare group NPD
• Barbara Ann Karmanos Cancer Institute

  • Mammography Clinic/Center
  • Detroit, MI
  • NPI 1225022288
  Medicare reassignment NPD
• Barbara Ann Karmanos Cancer Institute

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Detroit, MI
  • NPI 1386060226
  NPD
• University Physician Group

  • Social Worker
  • Livonia, MI
  • NPI 1154360402
  NPD (past)

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

• Barbara Ann Karmanos Cancer Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1316900277
  Care Compare affiliation
• VHS Detroit Receiving Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1619289998
  Care Compare affiliation
• VHS Harper-Hutzel Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1427360700
  Care Compare affiliation
• VHS Huron Valley-Sinai Hospital Inc

  • General Acute Care Hospital
  • Commerce Township, MI
  • NPI 1922310200
  Care Compare affiliation

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1003135500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400 - CREDENTIALING DEPARTMENT",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "800-527-6266",
            "fax_number": "313-576-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "800-527-6266",
            "fax_number": "313-576-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINELLO",
        "first_name": "MICHAEL",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-24",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "5101019388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Domany, PA-C
• Mitchell P Dombrowski, MD
• Jamie Domenico, RD
• Domestic Home Help Care Service
• Domestic Life Services LLC
• Joy Domingo, RN
• Dominion Adult Day Care and Therapeutic Clinic
• Dominion Transportation LLC
• Rachael Domino, NP
• Cydney Domsic, PSYD

• Radiation Oncology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Radiation Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.