Dominique Leigh Petrie, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1732 Alexis Rd
Merrick, NY 11566-4821

Phone

(516) 606-0697

NPI assigned

Mar 3, 2014

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 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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Py Medical PLLCGroup PAC ID 2961840319, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

68.56

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Py Medical PLLC

  • Pain Medicine Physician
  • Bronx, NY
  • NPI 1043081524
  Medicare reassignment Care Compare group
• Laura Davids MD PC

  • Physical Medicine & Rehabilitation Physician
  • Dix Hills, NY
  • NPI 1063073971
  Medicare reassignment

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1205251014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 ALEXIS RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664821",
            "telephone_number": "516-606-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 ALEXIS RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664821",
            "telephone_number": "516-606-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "DOMINIQUE",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Perafan, MSED
• Kylie Pernice, LMSW
• Aldo Joseph Perrino, D.D.S.
• Melissa Lynn Perrino, DDS
• Sarah Peters
• Demetra Petrochilos
• Maria Petrolekas, PSY.D.
• Mary Louise Pettiweber, OTR
• Philip J. Cilio DC Lac PLLC
• Bini Philip

• Physician Assistant in Merrick, NY
• Providers in Merrick, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.