Dominic Omar Ansari, M.D., PH.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

285015 Issued in NY

Practice address

800 E Washington Blvd
Crescent City, CA 95531-8359

Phone

(707) 464-8511

NPI assigned

Jun 13, 2011

Last updated

May 29, 2019By the provider in NPPES

Sex

Male

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Weill Medical College of Cornell

  • Internal Medicine Physician
  • New York, NY
  • NPI 1124170212

  Pediatrics

  Medicare reassignment NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD
• Weill Medical College of Cornell

  dba CUMC Pediatrics

  • Pediatrics Physician
  • New York, NY
  • NPI 1629018205
  NPD
• Pediatric and Adolescent Urgent Care of Western New York

  dba Peds Urgent Care

  • Urgent Care Clinic/Center
  • Williamsville, NY
  • NPI 1922300516
  NPD (past)

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1366737942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LENORA ST # 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212411",
            "telephone_number": "512-766-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E WASHINGTON BLVD",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318359",
            "telephone_number": "707-464-8511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Maple Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142212749",
            "country_code": "US",
            "telephone_number": "716-636-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANSARI",
        "first_name": "DOMINIC",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "285015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allam Dalati (OrthoCare)
• Rachel Inez Allen, CADC I
• Samuel Ambrosia, RN
• Melinda Ann Anderson, MSW, PPSC
• Susan Margaret Andrews
• Applied Intervention
• Gustavo Chavez Aragones, RDH
• David Linn Archambault, PHD
• Carolina Arenas, LCSW
• Avery Armstrong, SLP

• Pediatrics Physician in Crescent City, CA
• Providers in Crescent City, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.