DR. IRINA DOMANTOVSKY M.D.
NPI 1316268303
Surgery - Plastic and Reconstructive Surgery in New York, NY

Active since June 14, 2010PECOS EnrolledAccepts Medicare Assignment
590 5TH AVE FL 11, NEW YORK, NY 10036(917) 387-7834 Get Directions Write a Review

NPPES record last updated: December 15, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 15, 2022, Oct 1, 2020, Aug 22, 2019 and 1 more (4 updates tracked since 2017).

About Dr. Irina Domantovsky M.d. NPPES

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

DR. IRINA DOMANTOVSKY M.D. (NPI 1316268303) is an individual plastic and reconstructive surgery provider in New York, New York, licensed in New York (300353) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of State University Of Ny Upstate Medical University (2010).

NPPES Registry Identity

NPI1316268303
Entity TypeIndividualFemale
Primary Taxonomy2086S0122X
Provider Legal NameDR. IRINA DOMANTOVSKYCredential: M.D.
Location Address590 5TH AVE FL 11New York, NY 10036-4748
Mailing AddressPo Box 220424Great Neck, NY 11022-0424 · (917) 387-7834
Sole ProprietorYes
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2010
Enumeration DateJune 14, 2010
Last NPPES UpdateDecember 15, 20224 updates tracked since enumeration
NPPES CertifiedDecember 15, 2022
NPI 1316268303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License Licensed in NY · 300353
Definition
A surgeon who specializes in plastic and reconstructive surgery.
Also ListedPlastic SurgeryTaxonomy 208200000X · License 300353 (NY)
590 5TH AVE FL 11, New York, NY 10036

Secondary Practice Locations 2

Location 1107 Northern Blvd Ste 203Great Neck, NY 11021 · Phone (516) 773-9200
Location 255 BroadwayBangor, ME 04401-5201 · Phone (207) 947-5657 · Fax (207) 947-1894

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

Dr. Irina Domantovsky M.d. 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 ID3678872470
PECOS Enrollment IDI20190919001752
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.

Other Providers at the Same Location NPPES

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

Surgery (Plastic and Reconstructive Surgery)
590 5TH AVE FL 11
NEW YORK, NY 10036

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 Irina Domantovsky's NPI number?

The NPI number for Irina Domantovsky is 1316268303. It was assigned to this individual provider in the NPPES registry on June 14, 2010.

Where is Irina Domantovsky located?

Irina Domantovsky practices at 590 5th Ave Fl 11, New York, NY 10036. The listed phone number is (917) 387-7834.

What is Irina Domantovsky's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Irina Domantovsky enrolled in Medicare?

Yes. Irina Domantovsky 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.

When was this NPI record last updated?

The NPPES record for Irina Domantovsky was last updated on December 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.