Dana Domanski-McNulty, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704270401 Issued in MI

Practice address

15830 Fort St
Southgate, MI 48195-1367

Phone

(734) 282-5444

NPI assigned

Jan 6, 2021

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

Enrolled in MI

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

Nurse Practitioner

Education

Sioux City College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Get Well Urgent Care Southgate PLCGroup PAC ID 9537575881, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Get Well Urgent Care Southgate PLC

  • Urgent Care Clinic/Center
  • Southgate, MI
  • NPI 1235722430
  Medicare reassignment Care Compare group NPD
• Get Well Urgent Care Taylor PLC

  • Urgent Care Clinic/Center
  • Taylor, MI
  • NPI 1689320012
  Medicare reassignment NPD
• Hoover Urgent Care of Warren PLLC

  • Urgent Care Clinic/Center
  • Warren, MI
  • NPI 1821351610
  Medicare reassignment NPD

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1760070635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15830 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951367",
            "telephone_number": "734-282-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15830 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951367",
            "telephone_number": "734-282-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMANSKI-MCNULTY",
        "first_name": "DANA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704270401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marley Rose Disanto
• Tiffany Ditzhazy
• Dix Eureka Medical Center
• Dix Eureka Medical Center PC
• Dix-Eureka Med Center PC
• Patricia Ann Donald, MA, LLPC
• Ciara Donaldson
• Desiree Donaldson
• Kaela Dorman
• Jacqueline Dostine

• Family Nurse Practitioner in Southgate, MI
• Providers in Southgate, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.