Lisa L Domagala (NPI# 1083726251, PAC ID# 0648279935) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1083726251 |
| PAC ID by PECOS | 0648279935 |
| Professional Enrollment ID | I20061214000318 |
| Full Name | Lisa L Domagala |
| Organization Legal Name | GREAT LAKES PHYSICIAN PC |
| Address |
500 Sterling Dr Orchard Park NY 14127-1573 |
| Phone Number | 7166772273 |
| Gender | F |
| Credential | PA |
| Graduation Year | 1997 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 9133434269 |
| Number of Group Practice Members | 52 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330279 | MERCY HOSPITAL OF BUFFALO |
| 330078 | SISTERS OF CHARITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3085 Harlem Rd, Suite 200, Cheektowaga, NY 14225-2591 | 7168445000 | GREAT LAKES PHYSICIAN PC |
| 500 Sterling Dr, Orchard Park, NY 14127-1573 | 7166772273 | GREAT LAKES PHYSICIAN PC |
| Organization Legal Name | GREAT LAKES PHYSICIAN PC |
| Physicians | 52 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Duff | Radiation Oncology | Great Lakes Physician PC | 3085 Harlem Rd, Suite 200, Cheektowaga, NY 14225-2591 |
| Surjeet S Pohar | Radiation Oncology | Great Lakes Physician PC | 3850 Saunders Settlement Rd, Sanborn, NY 14132-9128 |
| Anthony R Ricottone | Urology | Great Lakes Physician PC | 500 Sterling Dr, Orchard Park, NY 14127-1573 |
| Kirsten Bishop | Physician Assistant | Great Lakes Physician PC | 3085 Harlem Rd, Suite 200, Cheektowaga, NY 14225-2591 |
| Kevin J Barlog | Urology | Great Lakes Physician PC | 3085 Harlem Rd, Suite 200, Cheektowaga, NY 14225-2591 |
| Karen A Pane | Nurse Practitioner | Great Lakes Physician PC | 3085 Harlem Rd, Suite 200, Cheektowaga, NY 14225-2591 |
| Abeer Eddib | Obstetrics/gynecology | Great Lakes Physician PC | 3085 Harlem Rd, Suite 200, Cheektowaga, NY 14225-2591 |
| Brian D Rambarran | Urology | Great Lakes Physician PC | 3850 Saunders Settlement Rd, Sanborn, NY 14132-9128 |
| Katrina Michelle Vankouwenberg | Physician Assistant | Great Lakes Physician PC | 3850 Saunders Settlement Rd, Sanborn, NY 14132-9128 |
| Olia Golimowski | Nurse Practitioner | Great Lakes Physician PC | 3085 Harlem Rd, Suite 200, Cheektowaga, NY 14225-2591 |
| Street Address |
500 STERLING DR |
| City | ORCHARD PARK |
| State | NY |
| Zip | 14127-1573 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony R Ricottone | Urology | Great Lakes Physician PC | 500 Sterling Dr, Orchard Park, NY 14127-1573 |
| Phillip J Seereiter Jr. | Urology | Great Lakes Physician PC | 500 Sterling Dr, Orchard Park, NY 14127-1573 |
| Mark J Doerr | Urology | Great Lakes Physician PC | 500 Sterling Dr, Orchard Park, NY 14127-1573 |
| Carlo M Perfetto | Urology | Great Lakes Physician PC | 500 Sterling Dr, Orchard Park, NY 14127-1573 |
| Matthew Stephen Radel | Physician Assistant | Great Lakes Physician PC | 500 Sterling Dr, Orchard Park, NY 14127-1573 |
| Christopher F Kopp | Urology | Great Lakes Physician PC | 500 Sterling Dr, Orchard Park, NY 14127-1573 |
| Louis R Baumann | Urology | Great Lakes Physician PC | 500 Sterling Dr, Orchard Park, NY 14127-1573 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Keith C Kaplan | Diagnostic Radiology | Sra Medical Imaging LLC | 3669 Southwestern Blcd, Orchard Park, NY 14127 |
| David M Fisher | Orthopedic Surgery | S-3673 Southwestern Blvd, Orchard Park, NY 14127 | |
| David Samuel Bevilacqua | Orthopedic Surgery | S-3673 Southwestern Blvd, Orchard Park, NY 14127 | |
| John Pasier | Chiropractic | 3117 Abbott Rd, Orchard Park, NY 14127-1005 | |
| Sridhar Nilam | Addiction Medicine | Bestself Behavioral Health Inc | 3176 Abbott Rd A, Orchard Park, NY 14127-1069 |
| Ann Marie Pasek | Nurse Practitioner | Bestself Behavioral Health Inc | 3176 Abbott Rd, Suite 500, Orchard Park, NY 14127-1069 |
| Bradley K Hamm | Clinical Social Worker | Bestself Behavioral Health Inc | 3176 Abbott Rd A, Orchard Park, NY 14127-1069 |
| Julie M Rivera | Clinical Social Worker | Bestself Behavioral Health Inc | 3176 Abbott Rd A, Orchard Park, NY 14127-1069 |
| Jamy L Stammel | Clinical Social Worker | Bestself Behavioral Health Inc | 3176 Abbott Rd A, Orchard Park, NY 14127-1069 |
| Paul L Fazekas | Nurse Practitioner | Bestself Behavioral Health Inc | 3176 Abbott Rd A, Orchard Park, NY 14127-1069 |
| Find all physicians in zip 14127 | |||
| City | ORCHARD PARK |
| Zip Code | 14127 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | ORCHARD PARK + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Lisa L Domagala.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.