Andrea Mead Dominey, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

M-8263 Issued in ID

Practice address

1807 N Hutchinson Rd
Spokane Valley, WA 99212-2444

Phone

(509) 456-7414

Fax

(509) 624-0763

NPI assigned

Oct 5, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mountain West Derm - Blackhart PLLC

  • Dermatology Physician
  • Spokane Valley, WA
  • NPI 1013557933

  Dermatology, WA

  Medicare reassignment NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Tigard, OR
  • NPI 1316656994

  Dermatology

  NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Boise, ID
  • NPI 1548758501

  Dermatology

  NPD
• Inland Empire Hospital Services Association

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1326002163
  NPD (past)
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1215023007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 N HUTCHINSON RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992122444",
            "telephone_number": "509-456-7414",
            "fax_number": "509-624-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 N HUTCHINSON RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992122444",
            "telephone_number": "509-456-7414",
            "fax_number": "509-624-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINEY",
        "first_name": "ANDREA",
        "middle_name": "MEAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "M-8263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003663100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8159071",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blaine Dodson, D.M.D.
• Alyson E. Doede, L.M.P.
• Richard C Doede, D.C.
• Gregory J Doering, M.D.
• Jina Doggett
• Kevin John Donahoe, MD
• Lindsay Donahue, N.D.
• Donald K Williams DO PC
• Nicole A Donaldson
• Sahteevah Donatelli

• All providers in Spokane Valley, WA
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.