NPIMap

Individual provider Active NPI

Lisa R Domagalski, MD

  • Obstetrics & Gynecology Physician
  • Charleston, SC
National Provider Identifier
1295782787
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD96104 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-0100
Phone
(843) 792-1414
NPI assigned
May 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD96104 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-0100

Mailing address

PO Box 751461
Charlotte, NC 28275-1461

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040203000393 RI Practitioner - Obstetrics/Gynecology 4385537596 Reassigns benefits to 2 organizations
I20260203002682 SC Practitioner - Obstetrics/Gynecology 4385537596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Tufts University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern New England Healthcare for Women, LLCGroup PAC ID 0042486649, 26 clinicians

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

333 School St
Suite 205
Pawtucket, RI 02860-5336
Phone (401) 724-0600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD96104SCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Jan 1, 2017 Accepting new patients
Southern New England Healthcare for Women, LLC Obstetrics & Gynecology CurrentSince Nov 1, 2011 Accepting new patients
University Medical Associates of the Medical University of South Carol Obstetrics & Gynecology CurrentSince Feb 1, 2026 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Feb 1, 2026 Accepting new patients
Affinity Physicians LLC. Obstetrics & Gynecology CurrentSince Jan 1, 2017 Accepting new patients
Partners in Obstetrics and Gynecology Obstetrics & Gynecology PastSince Jan 1, 2007 Accepting new patients

Locations

333 School St
Ste 200
Pawtucket, RI 02860
Phone (401) 724-0600

333 School St
Ste 205
Pawtucket, RI 02860
Phone (401) 724-0600

695 Eddy St
Ste 21
Providence, RI 02903
Phone (401) 272-1550

297 Promenade St
Providence, RI 02908
Phone (401) 490-6464

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

1525 Wampanoag Trl
Ste 201
Riverside, RI 02915

1525 Wampanoag Trl
Riverside, RI 02915
Phone (401) 433-4049

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: lisa.domagalski.1@3516.direct.athenahealth.com
  • Direct secure messaging: ldomagalski@wih.cernerdirect.carene.org

Organizations & group practices 7

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1295782787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250100",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAGALSKI",
        "first_name": "LISA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "MD96104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294250100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.