NPIMap

Individual provider Active NPI

Kristina Halina Domanski, M.D

  • Emergency Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1417213869
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
16880 Issued in NV
Practice address
1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone
(702) 383-1958
NPI assigned
Apr 10, 2012
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q4390 TX
Emergency Medicine Physician 207P00000X 16880 NV Primary

Addresses

Primary practice location

1800 W Charleston Blvd
Las Vegas, NV 89102-2329

Mailing address

1800 W Charleston Blvd
Las Vegas, NV 89102-2386
Phone (702) 383-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170602000101 NV Practitioner - Emergency Medicine 3274841739 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16880NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Emergency Services Scherr LTD Emergency Medicine CurrentSince Apr 18, 2017 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Jul 1, 2024 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Jul 1, 2024 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine Current Accepting new patients
Sound Physicians Emergency Medicine of Nevada Bessler PLLC Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine Past Accepting new patients

Locations

10770 Las Vegas Blvd S
Las Vegas, NV 89183
Phone (702) 916-9004

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

3186 S Maryland Pkwy
Ste 410
Las Vegas, NV 89109

3325 S Fort Apache Rd
Las Vegas, NV 89117
Phone (702) 962-0500

9300 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 880-2100

7207 Aliante Pkwy
North Las Vegas, NV 89084
Phone (702) 962-5100

2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000

Organizations & group practices 6

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.

Hospital & facility affiliations 12

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1417213869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022386",
            "telephone_number": "702-383-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022329",
            "telephone_number": "702-383-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMANSKI",
        "first_name": "KRISTINA",
        "middle_name": "HALINA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q4390",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "16880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.