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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 30591200 | 05 | |
WI | DEAN HEALTH INSURANCE | 731 | 01 |
Street Address |
700 S PARK ST |
City | MADISON |
State | WI |
Zip Code | 53715-1830 |
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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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 Code | 2084N0402X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology with Special Qualifications in Child Neurology |
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] |
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 |
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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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.