Individual provider Active NPI

Joseph Dominick, COTA/L

  • Occupational Therapy Assistant
  • Latrobe, PA
National Provider Identifier
1881463644
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OP005799 Issued in PA
Practice address
1567 Buffenmeyer Rd
Latrobe, PA 15650-4713
Phone
(724) 961-2332
NPI assigned
Dec 21, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OP005799 PA Primary

Addresses

Primary practice location

1567 Buffenmeyer Rd
Latrobe, PA 15650-4713

Mailing address

1567 Buffenmeyer Rd
Latrobe, PA 15650-4713
Phone (724) 961-2332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OP005799PAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1881463644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 BUFFENMEYER RD",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156504713",
            "telephone_number": "724-961-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1567 BUFFENMEYER RD",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156504713",
            "telephone_number": "724-961-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICK",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP005799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latrobe, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.