Renaissance Plastic Surgery PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

RENAISSANCE PLASTIC SURGERY PLLC

Practice address

590 5TH Ave FL 11
New York, NY 10036-4748

Phone

(917) 387-7834

NPI assigned

Dec 12, 2022

Organization subpart

No

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

Authorized official

Name

Irina Domantovsky, MDNPI 1316268303

Title

President

Phone

(917) 387-7834

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Irina Domantovsky, M.D.

  • Plastic and Reconstructive Surgery Physician
  • New York, NY
  • NPI 1316268303
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1639880677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220424",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110220424",
            "telephone_number": "917-387-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 5TH AVE FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364748",
            "telephone_number": "917-387-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE PLASTIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "DOMANTOVSKY",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-387-7834",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Michael Renacci, MD
• Daniel Renahan
• Renaissance Heaith Care
• Renaissance Health Care Network
• Renaissance Heights LLC
• Jasmine Rename
• Kathryn Brooke Renard, MD
• Anna Marie Renardo
• Renascent Health Center
• Renat Arslanov Pediatrics, LLC

• Plastic and Reconstructive Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Plastic and Reconstructive Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.