Damian Jerzy Domanski, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

11493948-1205 Issued in UT

Practice address

1160 E 3900 S Ste 2000
Salt Lake City, UT 84124-1236

Phone

(801) 266-3418

Fax

(801) 266-4174

NPI assigned

Aug 15, 2008

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mountainstar Cardiology St Marks LLCGroup PAC ID 2961661855, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lone Peak Hospital Hospital, Draper, UT, CCN 460060
• St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
• University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
• Timpanogos Regional Hospital Hospital, Orem, UT, CCN 460052

Merit-based Incentive Payment System (MIPS)

Final score

88.44 of 100Reported as group

Quality

88.05

Promoting interoperability

98

Improvement activities

40

Cost

75.07

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Mountainstar Cardiology St Marks LLC

  • Interventional Cardiology Physician
  • Salt Lake City, UT
  • NPI 1437446168
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lone Peak Hospital, Inc.

  • General Acute Care Hospital
  • Draper, UT
  • NPI 1770821571
  Care Compare affiliation
• Northern Utah Healthcare Corporation

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation
• Timpanogos Regional Medical Services, Inc.

  • General Acute Care Hospital
  • Orem, UT
  • NPI 1497702195
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1487734976
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  Care Compare affiliation

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1508012030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741729",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E 3900 S STE 2000",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241236",
            "telephone_number": "801-266-3418",
            "fax_number": "801-266-4174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 E Kimballs Ln Ste 330",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840205006",
            "country_code": "US",
            "telephone_number": "801-266-3418",
            "fax_number": "801-266-4174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMANSKI",
        "first_name": "DAMIAN",
        "middle_name": "JERZY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2022-01-04",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "11493948-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092152",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100268970",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddomanski118525@epicmtn.hcadirect.net",
            "affiliation": "N",
            "address_1": "74 E Kimballs Ln Ste 330",
            "city": "Draper",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840205006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Shawna Domingo, LPN
• Skylar Domingo
• Carlos R. Dominguez, MD

• Cardiovascular Disease Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Cardiovascular Disease Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.

Verify at the official NPI Registry.