Active NPI
Alexandra Lee Dominik, MD
- Anesthesiology Physician
- Frankfort, IN
National Provider Identifier
1699737957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01028190A
- Practice address
- 1300 S Jackson St
Frankfort, IN 46041-3313 - Phone
- (765) 656-3000
- NPI assigned
- Apr 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01028190A | IN | Primary |
Addresses
Primary practice location
1300 S Jackson St
Frankfort, IN 46041-3313
Mailing address
8840 Commerce Park PL Ste E
Indianapolis, IN 46268-3129
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100082910 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01028190A | IN | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418256000000",
"number": "1699737957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8840 COMMERCE PARK PL STE E",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462683129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 S JACKSON ST",
"city": "FRANKFORT",
"state": "IN",
"postal_code": "460413313",
"telephone_number": "765-656-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINIK",
"first_name": "ALEXANDRA",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-03",
"last_updated": "2014-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01028190A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100082910",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frankfort, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.