Emilissa Jane Domingo, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

243270 Issued in NY

Practice address

1000 Montauk Hwy
West Islip, NY 11795-4927

Phone

(631) 376-4045

NPI assigned

May 22, 2008

Sex

Female

Sole proprietor

Yes

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 RI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1053578476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 8TH AVE",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117355738",
            "telephone_number": "516-293-0451",
            "fax_number": "516-293-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "EMILISSA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "243270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William David Disanti, M.D.
• Olivia Disilvestre, MS, GC
• Theresa Ann Doerler, MS ED.
• Kazim Doganay, M.D. PLLC
• Kerry Ann Dollard
• Rodolfo M Domingo, MD
• Megan Donlevy, NP
• Breeanna Donovan, D.P.T.
• Sara Elinor Dookram, MA, CCC/SLP
• Dorine D'Angelo, LCSW (Enlightened Insights)

• Emergency Medicine Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.