Dominique Lassen Krzykos

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

14210 N 13TH St
Phoenix, AZ 85022-4407

Phone

(602) 828-7855

NPI assigned

Jun 27, 2023

Sex

Female

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 NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013
• Bellevue Medical Center Hospital, Bellevue, NE, CCN 280132

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: dkrzykos426190@direct.nebraskamed.com

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.

• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment Care Compare group

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

• Bellevue Medical Center LLC

  • General Acute Care Hospital
  • Bellevue, NE
  • NPI 1609007525
  Care Compare affiliation
• The Nebraska Medical Center

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356307581
  Care Compare affiliation

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1093491748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14210 N 13TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14210 N 13TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224407",
            "telephone_number": "602-828-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRZYKOS",
        "first_name": "DOMINIQUE",
        "middle_name": "LASSEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerrie Kruse
• Kruskamd Murrillo Inc
• Maria Rosario Krusmark
• Kevin Kryder, D.D.S.
• Kryten Holdings
• KS Az-1, PC
• KSC Care
• KTL Plastic Surgery
• Cheryl Lynn Kubacz, NMD
• Laurel A Kubby, MD

• Student in an Organized Health Care Education/Training Program in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Student in an Organized Health Care Education/Training Program in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.