Kellie Dominessy, PA-C, MMS, ATC
NPI 1932403383 · Surgical Physician Assistant · Fort Lauderdale, FL
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kellie Dominessy, PA-C, MMS, ATC is a Surgical Physician Assistant provider in Fort Lauderdale, FL (NPI 1932403383).
Provider details
- NPI number
- 1932403383
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C, MMS, ATC
- Sex
- Female
- Sole proprietor
- No
- License
- PA9105661 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-12-28
- Last updated
- 2016-03-28
Frequently asked questions
- What is Kellie Dominessy's NPI number?
- Kellie Dominessy's National Provider Identifier (NPI) is 1932403383, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kellie Dominessy's specialty?
- Kellie Dominessy is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kellie Dominessy located?
- Kellie Dominessy's practice location on file with NPPES is 2307 W Broward Blvd, Fort Lauderdale, FL 33312-1417.
- What is Kellie Dominessy's phone number?
- The practice phone number listed in the NPPES registry for Kellie Dominessy is (954) 792-1010.
- Does Kellie Dominessy accept Medicare?
- Kellie Dominessy is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kellie Dominessy's NPI active?
- Yes — Kellie Dominessy's NPI (1932403383) is active in the NPPES registry as of the last update on 2016-03-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.