Mikhail V Domnine, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0009827 Issued in MD

Practice address

12850 Middlebrook Rd Ste 410
Germantown, MD 20874-5281

Phone

(301) 652-8847

NPI assigned

Oct 20, 2006

Last updated

Jul 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centers for Advanced ENT Care LLCGroup PAC ID 1658647359, 103 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.14 of 100Reported as group

Quality

65.71

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Centers for Advanced ENT Care, LLC

  • Otolaryngology Physician
  • Baltimore, MD
  • NPI 1447781620

  DC

  Medicare reassignment Care Compare group
• Straka & McQuone Inc

  • Physical Therapist
  • Sewickley, PA
  • NPI 1700929494
  NPD
• Charlotte Eye Ear Nose & Throat Associates, P.a.

  • Ophthalmology Physician
  • Charlotte, NC
  • NPI 1043287469

  Physician Assistant

  NPD (past)
• Pinnacle ENT Alliance LLC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Wayne, PA
  • NPI 1538230313
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1659453454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12850 MIDDLEBROOK RD STE 410",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745281",
            "telephone_number": "301-652-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12850 MIDDLEBROOK RD STE 410",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745281",
            "telephone_number": "301-652-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMNINE",
        "first_name": "MIKHAIL",
        "middle_name": "V",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052604",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001001114",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "164XJ",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVOLUTIONS HEALTHCARE SYSTEMS",
            "identifier": "2687",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7790899",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald Eugene Dixon Jr., CSFA
• Florence Tchetgna Djikimi, NP-C
• DMV Wellness Center, LLC
• Doctors First, LLC (First Medical Associates)
• Adjoa Doe
• Rebecca Donahue, LMSW
• Anne Donohue, LCSW-C
• Keith Robert Donovan, P.T.
• Negheen Natasha Dorost
• Nicole Rae Dorshorst, DPT

• Physician Assistant in Germantown, MD
• Providers in Germantown, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.