Individual provider Active NPI

Nicole Elise Dominach, DNP, APRN, AGPCNP-BP

  • Adult Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1851916431
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309643 Issued in NY
Practice address
601 Elmwood Ave.
Rochester, NY 14642-0001
Phone
(585) 242-1300
Fax
(585) 473-5007
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 309643 NY Primary
Registered Nurse 163W00000X 771327-01 NY

Addresses

Primary practice location

601 Elmwood Ave.
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave Box 604
Rochester, NY 14642-0001
Phone (585) 275-1385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20210526000541 NY Practitioner - Nurse Practitioner 5193124089 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
U of R Anesthesiology GroupGroup PAC ID 3476451105, 340 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-2141

Hospital & facility affiliations

  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
771327-01NYMDRegistered Nurse
F309643-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
U of R Anesthesiology Group CurrentSince May 22, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 13, 2021 Accepting new patients
University of Rochester CurrentSince May 22, 2023 Accepting new patients
University of Rochester CurrentSince May 22, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 13, 2021 Accepting new patients
University of Rochester Current Accepting new patients

Locations

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

325 W 15th St
New York, NY 10011
Phone (212) 523-5938

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

601 Elmwood Ave
#604
Rochester, NY 14642
Phone (585) 275-2141

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1851916431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 604",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE.",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-242-1300",
            "fax_number": "585-473-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINACH",
        "first_name": "NICOLE",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, AGPCNP-BP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309643",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "771327-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.