NPIMap

Individual provider Active NPI

Dominique Swain, PA-C

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1629540141
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.000542 Issued in CO
Practice address
1644 Medical Center PT Ste 200
Colorado Springs, CO 80907-5765
Phone
(719) 634-1994
NPI assigned
Dec 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.000542 CO Primary

Addresses

Primary practice location

1644 Medical Center PT Ste 200
Colorado Springs, CO 80907-5765

Mailing address

1644 Medical Center PT Ste 200
Colorado Springs, CO 80907-5765
Phone (719) 634-1994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190129001086 CO Practitioner - Physician Assistant 8325385362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1644 Medical Ctr PT
Suite 200
Colorado Springs, CO 80907-5765
Phone (719) 634-1994

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.000542COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Springs Urological Associates LLC CurrentSince Jun 15, 2020 Accepting new patients

Locations

1644 Medical Center Pt
Colorado Springs, CO 80907
Phone (717) 776-4712

1644 Medical Center Pt
Ste 200
Colorado Springs, CO 80907
Phone (719) 634-1994

Organizations & group practices 1

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.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1629540141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 MEDICAL CENTER PT STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075765",
            "telephone_number": "719-634-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 MEDICAL CENTER PT STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075765",
            "telephone_number": "719-634-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "DOMINIQUE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-21",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.000542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.