Individual provider Active NPI

Gerald F Dominick, PA C

  • Physician Assistant
  • Chesapeake, VA
National Provider Identifier
1861478216
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110000927 Issued in VA
Practice address
113 Gainsborough SQ Ste 400
Chesapeake, VA 23320-1714
Phone
(757) 842-4499
Fax
(757) 842-4490
NPI assigned
Dec 19, 2005
Last updated
May 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110000927 VA Primary
Physician Assistant 363A00000X PA102599 MA
Physician Assistant 363A00000X PA219354 OR

Addresses

Primary practice location

113 Gainsborough SQ Ste 400
Chesapeake, VA 23320-1714

Mailing address

667 Kingsborough SQ Ste 101
Chesapeake, VA 23320-4999
Phone (757) 842-4481

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-3278

Other identifiers 5

IdentifierTypeStateIssuer
P00318486OtherVARR MEDICARE
10005129POtherVAOPTIMA
1861478216MedicaidVA
139178OtherVABCBS
10005129POtherVASENTARA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gdominick291247@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, VT, OR, MA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20051129000998 VA Practitioner - Physician Assistant 0749200277 Reassigns benefits to 3 organizations
I20230406001282 VT Practitioner - Physician Assistant 0749200277 Reassigns benefits to 1 organization
I20240328003819 OR Practitioner - Physician Assistant 0749200277 Reassigns benefits to 1 organization
I20260601001237 MA Practitioner - Physician Assistant 0749200277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Regional Medical GroupGroup PAC ID 8426113663, 148 clinicians
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

113 Gainsborough SQ
Chesapeake, VA 23320-1714

300 Medical Pkwy
Chesapeake, VA 23320-4985

600 Gresham Dr
Norfolk, VA 23507-1904

736 Battlefield Blvd N
Chesapeake, VA 23320-4941
Phone (757) 312-6102

744 Battlefield Blvd N
Chesapeake, VA 23320-4941
Phone (757) 312-3132

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA102599MAMDPhysician Assistant
PA219354ORMDPhysician Assistant
0110000927VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis CurrentSince Apr 15, 2024 Accepting new patients
Sentara Medical Group CurrentSince Feb 6, 2006 Accepting new patients
Chesapeake Regional Medical Group CurrentSince Jan 28, 2025 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Apr 15, 2024 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Mar 30, 2023 Accepting new patients
Chesapeake Regional Medical Group Physician Assistant CurrentSince Jan 28, 2025 Accepting new patients

Locations

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

667 Kingsborough Sq
Ste 101
Chesapeake, VA 23320
Phone (757) 312-3132

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

300 Medical Pkwy
Chesapeake, VA 23320
Phone (757) 312-6102

113 Gainsborough Sq
Ste 400
Chesapeake, VA 23320
Phone (757) 436-0167

4000 Coliseum Dr
Ste 320
Hampton, VA 23666
Phone (757) 827-2350

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

844 Kempsville Rd
Ste 212
Norfolk, VA 23502
Phone (757) 261-5977

600 Gresham Dr
#8600
Norfolk, VA 23507
Phone (757) 388-6005

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

Interoperability endpoints

  • Direct secure messaging: gerald.dominick.1@5072.direct.athenahealth.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1861478216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 KINGSBOROUGH SQ STE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204999",
            "telephone_number": "757-842-4481",
            "fax_number": "757-466-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 GAINSBOROUGH SQ STE 400",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201714",
            "telephone_number": "757-842-4499",
            "fax_number": "757-842-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-3278",
            "fax_number": "508-334-7284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINICK",
        "first_name": "GERALD",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110000927",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA102599",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA219354",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00318486",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "10005129P",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861478216",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "139178",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "10005129P",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gdominick291247@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3640 NW Samaritan Dr Ste 120",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.