Stevenson Dominique, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

000512-P.A. Issued in PR

Practice address

8046 N 19TH Dr
Phoenix, AZ 85021-5154

Phone

(786) 356-1865

NPI assigned

Apr 7, 2020

Last updated

Aug 6, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20314/brand/1/csg/1/fhir/r4

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.

• Instacare PLLC

  • Specialist
  • Scottsdale, AZ
  • NPI 1932912474
  Medicare reassignment NPD
• Synergy Global Health Inc.

  • Plastic and Reconstructive Surgery Physician
  • Scottsdale, AZ
  • NPI 1477449221
  Medicare reassignment NPD
• Synergyhealth360 PLLC

  • Plastic and Reconstructive Surgery Physician
  • Scottsdale, AZ
  • NPI 1770472276
  Medicare reassignment NPD
• Jarvis Tzeng DO P a

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1104104488
  Medicare reassignment
• Midwest Wellness and Wound Care LLC

  • General Practice Physician
  • Tulsa, OK
  • NPI 1033904040

  AZ

  Medicare reassignment
• Synergy Physicians PLLC

  • Plastic and Reconstructive Surgery Physician
  • Scottsdale, AZ
  • NPI 1083271746
  NPD
• Az Skin Sub LLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1912618687
  NPD (past)

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1912536301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8046 N 19TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215154",
            "telephone_number": "786-356-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8046 N 19TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215154",
            "telephone_number": "786-356-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIQUE",
        "first_name": "STEVENSON",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "000512-P.A.",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "000512-P.A.",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah L. Dominick, MSW, LCSW
• Elizabeth Dominick, REGISTERED NURSE
• Marissa Nicole Dominick, DO
• Samuel Dominick III, D.D.S.
• Cindy Dominique
• Fadi Domit, MD
• Paul Dommer, D.O.
• Don Scott Herrmann PHD PLLC
• Suzanne Lee Don, M.D.
• Amellia Lynne Donahoo, OMT

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.