Courtney Michele Dominic, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS018584 Issued in PA

Practice address

160 E. Erie Avenue
St. Christopher'S Hospital for Children
Philadelphia, PA 19134

Phone

(215) 427-5000

NPI assigned

May 29, 2014

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 PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• STC Pediatrics LLC

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Philadelphia, PA
  • NPI 1144864547
  Medicare reassignment NPD
• STC Pediatrics LLC

  • Ophthalmology Physician
  • Newtown, PA
  • NPI 1548141997

  Pediatrics

  NPD
• STC Pediatrics LLC

  • Pediatric Hematology & Oncology Physician
  • Bethlehem, PA
  • NPI 1679112577
  NPD
• STC Pediatrics LLC

  • Pediatric Allergy/Immunology Physician
  • Philadelphia, PA
  • NPI 1003450420

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1770995482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E. ERIE AVENUE",
            "address_2": "ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19134",
            "telephone_number": "215-427-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIC",
        "first_name": "COURTNEY",
        "middle_name": "MICHELE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS018584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estrella Dominguez de la Rosa
• Carlos Alberto Dominguez Gonzalez
• Dominique Dominguez
• Lourdes Dominguez, BA
• Martin Dominguez, M.D., PH.D.
• Gaeten J Dominic, RNFA
• Dominion Healthcare Clinic LLC
• Dominion Home Care Services, LLC
• Sarah Lynn Domino, RD, LDN
• Robert W Doms, MD

• Pediatrics Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.