RENAISSANCE PLASTIC SURGERY PLLC
NPI 1639880677
Surgery - Plastic and Reconstructive Surgery in New York, NY
About Renaissance Plastic Surgery Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RENAISSANCE PLASTIC SURGERY PLLC (NPI 1639880677) is a healthcare organization registered as a plastic and reconstructive surgery in New York, New York and active in the NPI registry since December 2022. The organization lists Irina Domantovsky, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Renaissance Plastic Surgery Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Renaissance Plastic Surgery PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Renaissance Plastic Surgery PLLC's NPI number?
The NPI number for Renaissance Plastic Surgery PLLC is 1639880677. It was assigned to this organization in the NPPES registry on December 12, 2022.
Where is Renaissance Plastic Surgery PLLC located?
Renaissance Plastic Surgery PLLC is located at 590 5th Ave Fl 11, New York, NY 10036. The listed phone number is (917) 387-7834.
What is Renaissance Plastic Surgery PLLC's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.
Is Renaissance Plastic Surgery PLLC enrolled in Medicare?
Yes. Renaissance Plastic Surgery PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Renaissance Plastic Surgery PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Renaissance Plastic Surgery PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Renaissance Plastic Surgery PLLC was last updated on July 9, 2024. 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.
# Renaissance Plastic Surgery Pllc · NPI 1639880677
Plastic and Reconstructive Surgery organization in New York, New York. Organization record, active in the CMS NPPES registry since December 12, 2022.
## Identity
- **NPI:** 1639880677 (Entity type: Organization)
- **Enumerated:** December 12, 2022
- **Primary specialty:** Surgery - Plastic and Reconstructive Surgery · taxonomy 2086S0122X
- **Organization subpart:** No
- **Authorized official:** Irina Domantovsky, PRESIDENT
## Practice location
- **Address:** 590 5TH AVE FL 11, New York, NY 10036-4748
- **Phone:** (917) 387-7834
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Plastic and Reconstructive Surgery) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 9, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1639880677) · Data from the CMS NPPES public registry.