NPIMap

Individual provider Active NPI

Karen Ann Dominger, D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Stony Brook, NY
National Provider Identifier
1639216682
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
213617-1 Issued in NY
Practice address
100 Patriots Rd
Stony Brook, NY 11790-3318
Phone
(631) 444-8500
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 213617-1 NY Primary

Addresses

Primary practice location

100 Patriots Rd
Stony Brook, NY 11790-3318

Mailing address

100 Patriots Rd
Stony Brook, NY 11790-3318
Phone (631) 444-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110606000042 NY Practitioner - Internal Medicine 6305023144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

100 Patriots Rd
Stony Brook, NY 11790-3318
Phone (631) 444-8630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
73.89
Promoting interoperability
89
Improvement activities
40
Cost
75.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
213617-1NYMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office Current Accepting new patients
State of New York Comptrollers Office CurrentSince Mar 16, 2024 Accepting new patients

Locations

100 Patriots Rd
Stony Brook, NY 11790
Phone (631) 444-8500

Organizations & group practices 2

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1639216682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PATRIOTS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903318",
            "telephone_number": "631-444-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PATRIOTS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903318",
            "telephone_number": "631-444-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGER",
        "first_name": "KAREN",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "213617-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.