MARY K DOMINSKI


Address: 700 S Park St, Madison, WI 53715-1830
Phone: 6082602900

MARY K DOMINSKI (NPI# 1407895428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407895428
Entity Type Individual
Full Name MARY K DOMINSKI
Credential MD
Practice Address 700 S Park St
Madison
WI 53715-1830
Practice Telephone 6082602900
Practice Fax Number 6082603442
Mailing Telephone 6082602900
Mailing Fax Number 6082603442
Enumeration Date 2006-06-05
Last Update Date 2019-11-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084N0402X Psychiatry & Neurology
Specialization: Neurology with Special Qualifications in Child Neurology
26119-20 WI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WI 30591200 05
WI DEAN HEALTH INSURANCE 731 01

Office Location

Street Address 700 S PARK ST
City MADISON
State WI
Zip Code 53715-1830

Providers in the same location

NPI Name Taxonomy Address Enumeration
1134123003 Marilyn J Borst Surgery 700 S Park St, Madison, WI 53715-1830 2005-06-09
1487266714 Charlene Jenkins Nurse Practitioner 700 S Park St, Madison, WI 53715-1830 2020-08-18
1073130480 Amanda Mcafee Nurse Practitioner 700 S Park St, Madison, WI 53715-1830 2020-07-01
1235759150 Edriss Drammeh Nurse Practitioner 700 S Park St, Madison, WI 53715-1830 2020-04-21
1700424777 Elizabeth H Kuhn Nurse Anesthetist, Certified Registered 700 S Park St, Madison, WI 53715-1830 2019-12-20
1295373710 Lauren Nicole Tobasco Physician Assistant 700 S Park St, Madison, WI 53715-1830 2019-12-16
1629610795 Amanda L Schneider Nurse Anesthetist, Certified Registered 700 S Park St, Madison, WI 53715-1830 2019-10-10
1366092017 Mitchell John Wilkins Nurse Anesthetist, Certified Registered 700 S Park St, Madison, WI 53715-1830 2019-09-16
1578119285 Gary Terlizzi Nurse Anesthetist, Certified Registered 700 S Park St, Madison, WI 53715-1830 2019-08-18
1699327304 Ann R Madden Nurse Anesthetist, Certified Registered 700 S Park St, Madison, WI 53715-1830 2019-07-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851807697 Kristi M Batchelor Nurse Practitioner 20 S Park St Fl 4, Madison, WI 53715 2017-12-15
1578927026 Petra A Kelsey Family Medicine 1107 Emerald St, Madison, WI 53715 2016-04-11
1467889238 Group Health Cooperative of South Central Wi Durable Medical Equipment & Medical Supplies 740 Regent Street, Suite 106, Madison, WI 53715 2013-10-10
1275888760 Sandra Beth Miller Physician Assistant 700 S. Park, Suite A 404, Madison, WI 53715 2012-07-20
1134418486 Matthew Lochen Emergency Medicine 700 S. Park Street, Department of Emergency Medicine, Madison, WI 53715 2011-04-06
1225275720 Eileen J Breitweiser Social Worker 202 South Parkt Street, Madison, WI 53715 2009-01-21
1225293137 Kenneth H. Yuska, Md, Sc Orthopaedic Surgery 4726 East Towne Blvd., 110, Madison, WI 53715 2008-07-21
1063689727 Rachel I Kornik Dermatology Uw Health Dept of Dermatology 1 S. Park St, Administrative Office 7th Floor, Madison, WI 53715 2008-05-13
1144434911 Rebecca Sue Frye Pharmacist 1 South Park Street, Suite 101 Pharmacy, Madison, WI 53715 2007-05-10
1376755496 Eileen C. Scrivner Social Worker 1008 Fish Hatchery Road, Madison, WI 53715 2007-05-03
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Taxonomy Information

Taxonomy Code 2084N0402X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Neurology with Special Qualifications in Child Neurology

Taxonomy Definition

A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033521513 Varun Sreenivasan Psychiatry & Neurology 7730 Old Canton Rd Bldg A, Madison, MS 39110-9299 2014-06-02
1063592301 Sergio Facchini Psychiatry & Neurology 600 Highland Ave, Madison, WI 53792-0001 2006-10-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1376963694 Shannon C Pollock Psychiatry & Neurology 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 2014-04-25
1972947224 Samuel J Adams Psychiatry & Neurology 9000 W Wisconsin Ave, Milwaukee, WI 53226 2013-04-17
1699036129 Alexandria Lynn Lutley Psychiatry & Neurology 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 2012-05-31
1063779601 Kumar R Sannagowdara Psychiatry & Neurology 12500 Aurora Dr, Pleasant Prairie, WI 53158-1227 2012-04-20
1942597356 Lileth Joy Mondok Psychiatry & Neurology 9000 W Wisconsin Avenue, Pediatric Neurology, Milwaukee, WI 53226-4874 2011-07-06
1144532052 Raquel Farias-moeller Psychiatry & Neurology 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 2010-07-08
1801002092 Delphin Sallowm Psychiatry & Neurology 9000 W Wisconsin Ave, Pediatric Neurology, Milwaukee, WI 53226-4874 2007-05-15
1659443620 Dorota Halina Telega Psychiatry & Neurology N84w16889 Menomonee Ave, Menomonee Falls, WI 53051-2810 2006-11-14
1003912346 Richard V Colan Psychiatry & Neurology 8825 S Howell Ave, Suite 101, Oak Creek, WI 53154-3760 2006-09-15
1053335513 Hema U Patel Psychiatry & Neurology 9000 W Wisconsin Ave, Pediatric Neurology, Milwaukee, WI 53226-4874 2006-07-27
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Competitor

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City MADISON
Zip Code 53715

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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