Individual provider Active NPI

Dominic James Catalano, MD

  • Otolaryngology Physician
  • Milwaukee, WI
National Provider Identifier
1639600224
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
76885 Issued in WI
Practice address
1155 N Mayfair Rd
Milwaukee, WI 53226-3462
Phone
(414) 955-5990
Fax
(414) 955-6282
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 76885 WI Primary

Addresses

Primary practice location

1155 N Mayfair Rd
Milwaukee, WI 53226-3462

Mailing address

1155 N Mayfair Rd
Milwaukee, WI 53226-3462
Phone (414) 955-5990

Other identifiers 1

IdentifierTypeStateIssuer
1639600224MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20230922002577 NC Practitioner - Otolaryngology 4688946726 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Chicago, Pritzker School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-1757

2303 Wellington Dr SW
Wilson, NC 27893-8620
Phone (252) 243-6818

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

850 Johns Hopkins Dr
Greenville, NC 27834-7222
Phone (252) 752-5227

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision21
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76885WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Carolina Ear, Nose & Throat-Head & Neck Surgery, Inc CurrentSince Oct 2, 2023 Accepting new patients
Vidant Medical Group LLC CurrentSince Oct 11, 2024 Accepting new patients

Locations

850 Johns Hopkins Dr
Greenville, NC 27834
Phone (252) 752-5227

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Interoperability endpoints

  • Direct secure messaging: dr.dominiccatalano@ecenthnspa.allscriptsdirect.net

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 3

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1639600224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263462",
            "telephone_number": "414-955-5990",
            "fax_number": "414-955-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263462",
            "telephone_number": "414-955-5990",
            "fax_number": "414-955-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATALANO",
        "first_name": "DOMINIC",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "76885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639600224",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.