Individual provider Active NPI

Paul C Domson, MD

  • Anesthesiology Physician
  • Reston, VA
National Provider Identifier
1346228178
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101054357 Issued in VA
Practice address
1850 Town Center Parkway
Reston Hospital Center
Reston, VA 20190
Phone
(703) 471-0919
Fax
(703) 742-9081
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101054357 VA Primary

Addresses

Primary practice location

1850 Town Center Parkway
Reston Hospital Center
Reston, VA 20190

Mailing address

PO Box 2757
Reston, VA 20195
Phone (703) 471-0919

Other identifiers 3

IdentifierTypeStateIssuer
050082174OtherRAILROAD MEDICARE
173386OtherANTHEM
005717213MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041020000202 DC Practitioner - Anesthesiology 2264493691 Reassigns benefits to 2 organizations
I20160108002277 VA Practitioner - Anesthesiology 2264493691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reston Anesthesia Associates PCGroup PAC ID 2567361124, 52 clinicians

Practice addresses (Care Compare)

1850 Town Ctr Pkwy
Reston, VA 20190-3204
Phone (703) 689-9000

Hospital & facility affiliations

  • Reston Hospital Center Hospital, Reston, VA, CCN 490107

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101054357VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stonesprings Anesthesia Associates, LTD Anesthesiology CurrentSince Nov 1, 2015 Accepting new patients
Reston Anesthesia Associates, PC Anesthesiology CurrentSince Sep 15, 2000 Accepting new patients
Outpatient Anesthesia Services of Reston, LTD Anesthesiology CurrentSince Apr 1, 2004 Accepting new patients
Winchester Anesthesiologists Inc Anesthesiology Past Accepting new patients

Locations

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

1860 Town Center Dr
Ste G100
Reston, VA 20190
Phone (703) 433-8700

24440 Stone Springs Blvd
Sterling, VA 20166
Phone (571) 206-8696

24570 Medical Dr
Sterling, VA 20166
Phone (571) 367-4400

Organizations & group practices 4

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 1

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1346228178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2757",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20195",
            "telephone_number": "703-471-0919",
            "fax_number": "703-742-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PARKWAY",
            "address_2": "RESTON HOSPITAL CENTER",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20190",
            "telephone_number": "703-471-0919",
            "fax_number": "703-742-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMSON",
        "first_name": "PAUL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101054357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050082174",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "173386",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005717213",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.