Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JOHNATHAN MARK DOMENICO PA-C
NPI 1346163367
Physician Assistant in Potsdam, NY

Active since August 04, 2026
8 CLARKSON AVE, POTSDAM, NY 13699(315) 268-2161 Get Directions Write a Review

NPPES record added: August 4, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Johnathan Mark Domenico Pa-c NPPES

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

JOHNATHAN MARK DOMENICO PA-C (NPI 1346163367) is an individual physician assistant in Potsdam, New York and active in the NPI registry since August 2026.

NPPES Registry Identity

NPI1346163367
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJOHNATHAN MARK DOMENICOCredential: PA-C
Location Address8 CLARKSON AVEPotsdam, NY 13699-1401
Mailing Address7134 Rickmeyer RdRome, NY 13440-6342
Sole ProprietorNo
Enumeration DateAugust 4, 2026
NPPES CertifiedAugust 4, 2026
NPI 1346163367 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.
8 CLARKSON AVE, Potsdam, NY 13699

Other Providers at the Same Location NPPES 4

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

Specialist/Technologist (Athletic Trainer)
8 CLARKSON AVE, ATHLETICS
POTSDAM, NY 13699
Specialist/Technologist (Athletic Trainer)
8 CLARKSON AVE
POTSDAM, NY 13699
Physician Assistant
8 CLARKSON AVE
POTSDAM, NY 13699
Physician Assistant
8 CLARKSON AVE
POTSDAM, NY 13699

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 Johnathan Domenico's NPI number?

The NPI number for Johnathan Domenico is 1346163367. It was assigned to this individual provider in the NPPES registry on August 4, 2026.

Where is Johnathan Domenico located?

Johnathan Domenico practices at 8 Clarkson Ave, Potsdam, NY 13699. The listed phone number is (315) 268-2161.

What is Johnathan Domenico's specialty?

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

When was this NPI record last updated?

The NPPES record for Johnathan Domenico was last updated on August 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.