Illy Dominitz, M.D.

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

0101228195 Issued in VA

Practice address

1468 Ingram St
Norfolk, VA 23551-2596

Phone

(757) 836-1685

Fax

(757) 836-1528

NPI assigned

Jan 31, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• U.S. Marine Corps Forces Command

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Camp Lejeune, NC
  • NPI 1699987438
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649317553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 INGRAM ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235512596",
            "telephone_number": "757-836-1685",
            "fax_number": "757-836-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 INGRAM ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235512596",
            "telephone_number": "757-836-1685",
            "fax_number": "757-836-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINITZ",
        "first_name": "ILLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "VA",
            "license": "0101228195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Dolsen, MD
• Nicole Domanico
• Dominion Eye Care PLLC
• Dominion Medical Supplies
• Dominion Pathology Laboratories PC
• Meaghan Dominy, MD
• Arina Aleksandroyna Donahue, NP
• David Alan Donahue, IDC
• Lauren Katherine Donahue, M.D.
• Mark Louis Donald II, PA-C

• Preventive Medicine/Occupational Environmental Medicine Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.