Individual provider Active NPI

Michal Domeny, L.AC, CD/N

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1942457965
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
337835 Issued in NY
Practice address
678 E 24TH St
Brooklyn, NY 11210-1132
Phone
(347) 693-7659
NPI assigned
Aug 20, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 006241-1 NY
Acupuncturist 171100000X 003443-1 NY
Adult Health Nurse Practitioner 363LA2200X 337835 NY Primary
Nurse Practitioner 363L00000X 645452-1 NY

Addresses

Primary practice location

678 E 24TH St
Brooklyn, NY 11210-1132

Mailing address

CMR 402 Box 1314
Apo, AE 09180-0014

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
006241-1NYMDNutritionist
003443-1NYMDAcupuncturist
645452-1NYMDNurse Practitioner
337835NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1942457965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "CMR 402 BOX 1314",
            "city": "APO",
            "state": "AE",
            "postal_code": "091800014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 E 24TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112101132",
            "telephone_number": "347-693-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMENY",
        "first_name": "MICHAL",
        "name_prefix": "Mr.",
        "credential": "L.AC, CD/N",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "006241-1",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "003443-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "337835",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "645452-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.