Active NPI
Donald Joseph Domenici, PHD
- Psychologist
- Carlisle, PA
National Provider Identifier
1134739360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS017144
- Practice address
- 28 S Pitt St
Carlisle, PA 17013-3211 - Phone
- (717) 713-7917
- NPI assigned
- Aug 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS017144 | PA | Primary |
Addresses
Primary practice location
28 S Pitt St
Carlisle, PA 17013-3211
Mailing address
28 S Pitt St
Carlisle, PA 17013-3211
Phone (717) 713-7917
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201028000529 | PA | Practitioner - Clinical Psychologist | 4486064730 | Practice locations: Carlisle, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
28 S Pitt St
Carlisle, PA 17013-3211
Phone (717) 423-8883
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS017144 | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603584000000",
"number": "1134739360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 S PITT ST",
"city": "CARLISLE",
"state": "PA",
"postal_code": "170133211",
"telephone_number": "717-713-7917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 S PITT ST",
"city": "CARLISLE",
"state": "PA",
"postal_code": "170133211",
"telephone_number": "717-713-7917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMENICI",
"first_name": "DONALD",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-03",
"last_updated": "2020-10-25",
"certification_date": "2020-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS017144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlisle, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; 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.