Individual provider Active NPI

Franklin Dedominicis, PA-C

  • Physician Assistant
  • Hamden, CT
National Provider Identifier
1871031492
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
23.003773 Issued in CT
Practice address
1952 Whitney Ave Ste 8
Hamden, CT 06517-1209
Phone
(203) 848-1803
Fax
(203) 848-1777
NPI assigned
Feb 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 23.003773 CT Primary

Addresses

Primary practice location

1952 Whitney Ave Ste 8
Hamden, CT 06517-1209

Mailing address

1952 Whitney Ave Ste 8
Hamden, CT 06517-1209
Phone (203) 848-1803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20170301001543 CT Practitioner - Physician Assistant 0547544066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Margaret Chustecka Internal Medicine of Greater New HavenGroup PAC ID 3274557152, 30 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

1952 Whitney Ave
Hamden, CT 06517-1209
Phone (203) 848-1803

831 Boston Post Rd
Milford, CT 06460-3536
Phone (203) 848-1803

98 Elm St
Suite 4
West Haven, CT 06516-3879
Phone (203) 848-1803

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23.003773CTMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: franklin.dedominicis@imgnh.eclinicaldirectplus.com

Organizations & group practices 1

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": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1871031492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 WHITNEY AVE STE 8",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065171209",
            "telephone_number": "203-848-1803",
            "fax_number": "203-848-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 WHITNEY AVE STE 8",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065171209",
            "telephone_number": "203-848-1803",
            "fax_number": "203-848-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDOMINICIS",
        "first_name": "FRANKLIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "23.003773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.