Michael A Domino, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2008-0031 Issued in NM

Practice address

505 Elm St NE
Albuquerque, NM 87102-2500

Phone

(505) 238-2027

NPI assigned

Jul 7, 2008

Sex

Male

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

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Manzano Medical Group, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Albuquerque, NM
  • NPI 1881704096

  NM

  Medicare reassignment
• Unm Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
  • NPI 1831218627

  NM

  Medicare reassignment
• Unm Medical Group, Inc.

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1417330044
  NPD

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1689837916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BRADBURY DR SE STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064310",
            "telephone_number": "505-272-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022500",
            "telephone_number": "505-238-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINO",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2008-0031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxann Israelle Dominguez, PHARMD
• Thomas Paul Dominguez, PHD
• William F. Dominguez, M.D.
• Anahi Dominicci, NP
• Kristine Domino
• Christie D Domme, FNP
• Mary Anne Domrzalski, CRNA
• Steven B Domrzalski, CRNA
• Jenna Domzalski de Rios, PHARMD
• Damaris Donado, LCSW

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.