Dominic Joseph Marchiafava, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085007984 Issued in IL

Practice address

411 W Foxdale LN
Arlington Heights, IL 60004-1307

Phone

(847) 452-5237

NPI assigned

Apr 19, 2020

Sex

Male

Sole proprietor

Yes

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment
• Trivedimd LLC

  • Pain Medicine (Anesthesiology) Physician
  • Chicago, IL
  • NPI 1639735608
  Medicare reassignment

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

{
    "created_epoch": "1587254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1497375554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W FOXDALE LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W FOXDALE LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041307",
            "telephone_number": "847-452-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHIAFAVA",
        "first_name": "DOMINIC",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-19",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Wirka Mantilla, SLP
• Jessica Natalie Marabella, M.D.
• Sailaja Maramreddy, MD
• Jonathan Maravilla
• Anthony Thomas March, DO
• Gina Marie Marcin, APRN FPA, CNM, LAC
• Bianca Marcu
• Snonita Marcus, LCSW
• Amy Kathryn Maren, OTR/L
• Margaret a Couch LCSW & Associates, LLC

• Physician Assistant in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.