Individual provider Active NPI

Dominique Celestin, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1114137957
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005368-1 Issued in NY
Practice address
26 Bleecker St
New York, NY 10012-2413
Phone
(212) 965-7000
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005368-1 NY Primary

Addresses

Primary practice location

26 Bleecker St
New York, NY 10012-2413

Mailing address

1160 E 86TH St
2ND Floor
Brooklyn, NY 11236-4737
Phone (347) 312-3208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20201214001365 NY Practitioner - Physician Assistant 3476965526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Planned Parenthood of Greater New York IncGroup PAC ID 7810293297, 34 clinicians

Practice addresses (Care Compare)

2141 45TH Rd
Long Island City, NY 11101-4706
Phone (516) 750-2500

349 E 149TH St
FL 2
Bronx, NY 10451-5603
Phone (212) 965-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005368-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of the Southern Finger Lakes Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1114137957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 E 86TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364737",
            "telephone_number": "347-312-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BLEECKER ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122413",
            "telephone_number": "212-965-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELESTIN",
        "first_name": "DOMINIQUE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005368-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.