Domenique Dicello Ward, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

MA059553 Issued in PA

Practice address

1200 Brooks LN Ste 170
Jefferson Hills, PA 15025-3759

Phone

(412) 469-7110

NPI assigned

Nov 1, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Domenique Dara Dicello Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Hospital Hospital, Jefferson Hills, PA, CCN 390265

Merit-based Incentive Payment System (MIPS)

Final score

93.9 of 100Reported as apm

Quality

85.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Allegheny Clinic

  dba AHN-Primary Care Bethel Park

  • Family Medicine Physician
  • Bethel Park, PA
  • NPI 1073081493
  Medicare reassignment
• Allegheny Clinic

  dba AHN Primary Care Mobile Clinic

  • Primary Care Clinic/Center
  • Pittsburgh, PA
  • NPI 1215752548
  NPD (past)

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

• Jefferson Regional Medical Center

  • Clinic/Center
  • Clairton, PA
  • NPI 1366488108

  Hospital

  Care Compare affiliation
• Jefferson Regional Medical Center

  • General Acute Care Hospital
  • Clairton, PA
  • NPI 1578560504
  Care Compare affiliation

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1548772460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5028 SHERWOOD RD",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151022024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BROOKS LN STE 170",
            "city": "JEFFERSON HILLS",
            "state": "PA",
            "postal_code": "150253759",
            "telephone_number": "412-469-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "DOMENIQUE",
        "middle_name": "DICELLO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA059553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddicello156409@direct.ahn.org",
            "affiliation": "N",
            "address_1": "1200 Brooks Ln Ste 170",
            "city": "Jefferson Hills",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150253759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DOMENIQUE",
            "last_name": "DICELLO",
            "middle_name": "DARA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haley Elizabeth Vranich, OTR/L
• Ashley Walbert
• Matthew Walbert, CRNA
• Elisabeth May Walls, PA-C
• Jeffrey Walters
• Barbara Jean Warden, OTR/L
• Gordon Hughes Watkins III, PHARMD
• Marshall Watson, CRNA
• Ryan Watson, M.D.
• James A Weber, CRNA

• Surgical Physician Assistant in Jefferson Hills, PA
• Providers in Jefferson Hills, PA by specialty
• Surgical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.