Dominic Jerome Giallombardo, MT(ASCP), RN, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005278 Issued in MI

Practice address

652 N Otsego Ave
Gaylord, MI 49735-2502

Phone

(989) 732-3529

Fax

(989) 732-7865

NPI assigned

Jul 16, 2008

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: dominic-giallombardo@alpinefamilymedicine.e-mdsdirect.com

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1033373352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 N OTSEGO AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497352502",
            "telephone_number": "989-732-3529",
            "fax_number": "989-732-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 N OTSEGO AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497352502",
            "telephone_number": "989-732-3529",
            "fax_number": "989-732-7865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "748 S Main St",
            "address_purpose": "LOCATION",
            "city": "Cheboygan",
            "state": "MI",
            "postal_code": "497212220",
            "country_code": "US",
            "telephone_number": "231-627-1282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIALLOMBARDO",
        "first_name": "DOMINIC",
        "middle_name": "JEROME",
        "name_prefix": "Mr.",
        "credential": "MT(ASCP), RN, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dominic-giallombardo@alpinefamilymedicine.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "652 N Otsego Ave",
            "city": "Gaylord",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497352502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Corrina Gourde

• Physician Assistant in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.