Jacob Dominik, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

257520 Issued in NY

Practice address

755 Jefferson Rd
Ste 110
Rochester, NY 14623-3233

Phone

(585) 419-7948

Fax

(585) 385-6071

NPI assigned

Jul 28, 2008

Last updated

Sep 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 5

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

NeurologyAlso: Sleep Medicine

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nicholas H Noyes Memorial HospitalGroup PAC ID 3072505536, 133 clinicians

Sleep Insights Medical Associates PLLCGroup PAC ID 8325345325, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nicholas H Noyes Memorial Hospital Hospital, Dansville, NY, CCN 330238

Merit-based Incentive Payment System (MIPS)

Final score

86.36 of 100Reported as group

Quality

64.11

Promoting interoperability

99

Improvement activities

40

Cost

78.12

Merit-based Incentive Payment System (MIPS)

Final score

93.22 of 100Reported as individual

Quality

85.9

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.dominik.1@22039.direct.athenahealth.com

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.

• Sleep Insights Medical Associates PLLC

  • Specialist
  • Rochester, NY
  • NPI 1457728420

  Sleep Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Nicholas H. Noyes Memorial Hospital

  • General Acute Care Hospital
  • Dansville, NY
  • NPI 1982625661
  Medicare reassignment Care Compare group NPD

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

• Nicholas H. Noyes Memorial Hospital

  • General Acute Care Hospital
  • Dansville, NY
  • NPI 1982625661
  Care Compare affiliation

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1629233861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 JEFFERSON RD",
            "address_2": "STE 110",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233233",
            "telephone_number": "585-419-7948",
            "fax_number": "585-385-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 JEFFERSON RD",
            "address_2": "STE 110",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233233",
            "telephone_number": "585-419-7948",
            "fax_number": "585-385-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIK",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "52196",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "104326",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME98936",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "257520",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MN",
            "license": "104326",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NY",
            "license": "257520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03400199",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - RAILROAD",
            "identifier": "P00804268",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS",
            "identifier": "P010257520",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Grace Domina, PA-C
• Nicole Elise Dominach, DNP, APRN, AGPCNP-BP
• Christine Dominas, MD
• Aleysha Ivette Dominguez, DPT
• Maria Dominguez, M.D.
• Tamara Domokos
• Kara Domuracki
• Randi Leah Donaghy-Bailey, LPN
• Brooke E Donaher, O.D.
• Dennis J. Donaher, D.M.D.

• Neurology Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.