Active NPI
Jaclyn K Dombroski, R-PAC
- Physician Assistant
- Liverpool, NY
National Provider Identifier
1407131253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 015222
- Practice address
- 7445 Morgan Rd
Liverpool, NY 13090-3989 - Phone
- (315) 420-5056
- NPI assigned
- Oct 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 015222 | NY | Primary |
Addresses
Primary practice location
7445 Morgan Rd
Liverpool, NY 13090-3989
Mailing address
7445 Morgan Rd
Liverpool, NY 13090-3989
Phone (315) 420-5056
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1001 W Fayette St
Suite 400
Syracuse, NY 13204-2866
Phone (315) 472-1488
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015222 | NY | MD | Mental Health Counselor |
Interoperability endpoints
- jdombroski@fcmg.medentdirect.com
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Syracuse, NY
- NPI 1447212063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746748800000",
"number": "1407131253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7445 MORGAN RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130903989",
"telephone_number": "315-420-5056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7445 MORGAN RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130903989",
"telephone_number": "315-420-5056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMBROSKI",
"first_name": "JACLYN",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "R-PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-12",
"last_updated": "2025-05-09",
"certification_date": "2025-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "015222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.