NPIMap

Individual provider Active NPI

Alexis N Dominiecki, PA-C

  • Physician Assistant
  • West Reading, PA
National Provider Identifier
1942918982
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA064016 Issued in PA
Practice address
301 S 7TH Ave Ste 3170
West Reading, PA 19611-1494
Phone
(484) 628-9386
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA064016 PA Primary
Physician Assistant 363A00000X OA006312 PA

Addresses

Primary practice location

301 S 7TH Ave Ste 3170
West Reading, PA 19611-1494

Mailing address

301 S 7TH Ave Ste 3170
West Reading, PA 19611-1494

Other identifiers 1

IdentifierTypeStateIssuer
1041308570020MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230120002588 PA Practitioner - Physician Assistant 3577934926 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Pennsylvania Infectious Disease Associates, LLCGroup PAC ID 9830293117, 3 clinicians

Practice addresses (Care Compare)

170 N Henderson Rd
Suite 310
King of Prussia, PA 19406-2155
Phone (610) 481-9600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA006312PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 23, 2023 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Sep 12, 2023 Accepting new patients
Family Care Centers Inc. CurrentSince Sep 12, 2023 Accepting new patients
Lehigh Valley Physician Group Physician Assistant CurrentSince Jan 23, 2023 Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

1431 Nursery St
Ste 101
Fogelsville, PA 18051
Phone (484) 273-4343

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

Organizations & group practices 7

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

Hospital & facility affiliations 10

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": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1942918982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S 7TH AVE STE 3170",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 7TH AVE STE 3170",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111494",
            "telephone_number": "484-628-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIECKI",
        "first_name": "ALEXIS",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064016",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA006312",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041308570020",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

Verify at the official NPI Registry.