James Domesek, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

ME86904 Issued in FL

Practice address

1314 E Las Olas Blvd Ste 898
Fort Lauderdale, FL 33301-2334

Phone

(954) 540-5410

Fax

(772) 460-6563

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Team Physicians, PC

  • Diagnostic Radiology Physician
  • Knoxville, TN
  • NPI 1942232194
  NPD (past)
• TPS IV of PA, LLC

  • Body Imaging Physician
  • Phila, PA
  • NPI 1740248905
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1831180082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 E LAS OLAS BLVD STE 898",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012334",
            "telephone_number": "954-540-5410",
            "fax_number": "772-460-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E LAS OLAS BLVD STE 898",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012334",
            "telephone_number": "954-540-5410",
            "fax_number": "772-460-6563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Broad and Vine Sts",
            "address_purpose": "LOCATION",
            "city": "Phila",
            "state": "PA",
            "postal_code": "19102",
            "country_code": "US",
            "telephone_number": "215-762-3619",
            "fax_number": "215-762-4517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMESEK",
        "first_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD039114L",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME86904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter J Dolan, PHARM.D.
• Louise Dolce
• Michael Dolchin, MD
• Liz-Aesha Dollisen
• Loraine Domado, PT
• Kellie Lynn Dominessy, PA-C, MMS, ATC
• Dominga'S Therapy Services PTR PA
• Dominga'S Therapy Services PTR. PA.
• Mayelin Dominguez Milian
• Caroline Lydia Dominguez

• Vascular & Interventional Radiology Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Vascular & Interventional Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.