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STEVENSON DOMINIQUE P.A.
NPI 1912536301
Physician Assistant - Medical in Phoenix, AZ

Active since April 07, 2020PECOS Enrolled
8046 N 19TH DR, PHOENIX, AZ 85021(786) 356-1865 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 6, 2025, Apr 7, 2020 (2 updates tracked since 2020).

About Stevenson Dominique P.a. NPPES

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

STEVENSON DOMINIQUE P.A. (NPI 1912536301) is an individual medical provider in Phoenix, Arizona, licensed in Puerto Rico (000512-P.A.) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912536301
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameSTEVENSON DOMINIQUECredential: P.A.
Location Address8046 N 19TH DRPhoenix, AZ 85021-5154
Mailing Address8046 N 19th DrPhoenix, AZ 85021-5154 · (786) 356-1865
Phone(786) 356-1865
Sole ProprietorNo
Enumeration DateApril 7, 2020
Last NPPES UpdateAugust 6, 20252 updates tracked since enumeration
NPPES CertifiedAugust 6, 2025
✔ NPI 1912536301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in PR · 000512-P.A.
Also ListedPhysician AssistantTaxonomy 363A00000X · License 000512-P.A. (PR)
8046 N 19TH DR, Phoenix, AZ 85021
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stevenson Dominique P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Stevenson Dominique's NPI number?

The NPI number for Stevenson Dominique is 1912536301. It was assigned to this individual provider in the NPPES registry on April 7, 2020.

Where is Stevenson Dominique located?

Stevenson Dominique practices at 8046 N 19th Dr, Phoenix, AZ 85021. The listed phone number is (786) 356-1865.

What is Stevenson Dominique's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Stevenson Dominique enrolled in Medicare?

Yes. Stevenson Dominique is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Stevenson Dominique was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.