Individual provider Active NPI

Dominic Philip Corsello, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Austin, TX
National Provider Identifier
1194302133
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
W9109 Issued in TX
Practice address
3418 N Lamar Blvd Ste 100
Austin, TX 78705-1176
Phone
(512) 244-4272
Fax
(512) 244-2895
NPI assigned
Mar 25, 2021
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X W9109 TX Primary

Addresses

Primary practice location

3418 N Lamar Blvd Ste 100
Austin, TX 78705-1176

Mailing address

101 W Louis Henna Blvd Ste 300
Austin, TX 78728-1203
Phone (512) 593-4444

Other practice location 1

2000 S Mays St Ste 201
Round Rock, TX 78664-7580
Phone (512) 244-4272

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210716000040 IL Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Internal MedicinePractitioner - Physical Medicine and Rehabilitation 4183026974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
W9109TXMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Interoperability endpoints

  • Direct secure messaging: dcorsello115354@uihealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1194302133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W LOUIS HENNA BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787281203",
            "telephone_number": "512-593-4444",
            "fax_number": "512-593-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 N LAMAR BLVD STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051176",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 S Mays St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786647580",
            "country_code": "US",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORSELLO",
        "first_name": "DOMINIC",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "TX",
            "license": "W9109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.