Dennis Domosi

Primary specialty

SpecialistTaxonomy code 174400000X

License

1533681 Issued in NY

Practice address

258 High Ave
Nyack, NY 10960-2407

Phone

(845) 353-1441

Fax

(845) 353-1987

NPI assigned

Oct 18, 2005

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 15

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Plains Medical Diagnostic Services, PCGroup PAC ID 5395918932, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: ddomosi1175204@nychhc.direct-ci.com

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.

• White Plains Medical Diagnostic Services, PC

  • Internal Medicine Physician
  • Nyack, NY
  • NPI 1689955338
  Medicare reassignment Care Compare group NPD
• Montefiore Nyack Hospital

  • Neurology Physician
  • Nyack, NY
  • NPI 1073881835
  Medicare reassignment NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment NPD
• Laboratory Medicine Associates, LLP

  • Anatomic Pathology & Clinical Pathology Physician
  • Nyack, NY
  • NPI 1740251578
  NPD
• Montefiore Nyack Hospital

  • General Acute Care Hospital
  • Nyack, NY
  • NPI 1104808062
  NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD
• New York City Health and Hospitals Corporation

  • Skilled Nursing Facility
  • New York, NY
  • NPI 1922016781
  NPD
• Obs-GYN of Rockland PC

  • Obstetrics & Gynecology Physician
  • New City, NY
  • NPI 1013958891
  NPD

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1568451995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 HIGH AVE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109602407",
            "telephone_number": "845-353-1441",
            "fax_number": "845-353-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 HIGH AVE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109602407",
            "telephone_number": "845-353-1441",
            "fax_number": "845-353-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMOSI",
        "first_name": "DENNIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1533681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO #",
            "identifier": "000000075204",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP #",
            "identifier": "153368",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TACONIC IPA #",
            "identifier": "363522",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE #",
            "identifier": "230544",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO #",
            "identifier": "4399282",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO #",
            "identifier": "0203731",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD #",
            "identifier": "P3098499",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AFFINITY HEALTH PLAN #",
            "identifier": "100004101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATLANTIS HEALTH PLAN #",
            "identifier": "DD3368",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00945253",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO #",
            "identifier": "0888254",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS #",
            "identifier": "675E41",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE #",
            "identifier": "153368",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP #",
            "identifier": "363522",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET #",
            "identifier": "0D3068",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Nyack, NY
• Providers in Nyack, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.