MS. EWELINA DOMANOWSKI
NPI 1124633169
Physician Assistant in Port Jefferson, NY

Active since September 15, 2020PECOS EnrolledAccepts Medicare Assignment
75 N COUNTRY RD, PORT JEFFERSON, NY 11777(631) 473-1320 Get Directions Write a Review

NPPES record last updated: August 15, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 15, 2023, Sep 15, 2020 (2 updates tracked since 2020).

About Ms. Ewelina Domanowski NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. EWELINA DOMANOWSKI (NPI 1124633169) is an individual physician assistant in Port Jefferson, New York and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS, is affiliated with John T Mather Memorial Hospital Of Port Jefferson, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1124633169
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. EWELINA DOMANOWSKI
Location Address75 N COUNTRY RDPort Jefferson, NY 11777-2119
Mailing Address57 N Lewis AveLindenhurst, NY 11757-4229 · (631) 988-2395
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 15, 2020
Last NPPES UpdateAugust 15, 20232 updates tracked since enumeration
NPPES CertifiedAugust 15, 2023
NPI 1124633169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
75 N COUNTRY RD, Port Jefferson, NY 11777

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Ewelina Domanowski is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082026885
PECOS Enrollment IDI20201221001429
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

John T Mather Memorial Hospital Of Port Jefferson

Acute Care Hospitals · Port Jefferson, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330185
Location75 North Country RoadPort Jefferson, NY 11777 · Suffolk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11777 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Dermatology
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Physician Assistant
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Nurse Practitioner (Family)
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ewelina Domanowski's NPI number?

The NPI number for Ewelina Domanowski is 1124633169. It was assigned to this individual provider in the NPPES registry on September 15, 2020.

Where is Ewelina Domanowski located?

Ewelina Domanowski practices at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 473-1320.

What is Ewelina Domanowski's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Ewelina Domanowski enrolled in Medicare?

Yes. Ewelina Domanowski is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Ewelina Domanowski affiliated with any hospitals?

According to CMS data, Ewelina Domanowski is affiliated with John T Mather Memorial Hospital Of Port Jefferson.

When was this NPI record last updated?

The NPPES record for Ewelina Domanowski was last updated on August 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.