NPI Lens

Ewelina Domanowski

NPI 1124633169ActiveIndividual· Physician Assistant· Port Jefferson, NY

Physician Assistant with John T Mather Memorial Hospital, practicing in Port Jefferson, New York. Part D covered 17 prescriptions written in 2024, 100% of them generic. Lists John T Mather Memorial Hospital of Port Jefferson as a hospital affiliation.

Overview

NPI1124633169
StatusActive
Entity typeIndividual
Sole proprietorYes
NPI issuedSep 15, 2020
Last updated in NPPESAug 15, 2023
Certified by providerAug 15, 2023

Specialties and licenses

TaxonomyCodeLicenseState
Physician Assistant Primary363A00000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 4, 2026No match—
New York OMIG · Nov 4, 2026No match—
Ohio Medicaid · Nov 4, 2026No match—
Pennsylvania Medicheck · Nov 4, 2026No match—
Washington HCA · Nov 4, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Physician Assistant (NY)

Part D prescriptions in 2024

Prescriptions (claims)17 · 17 30-day fills
Total drug cost$72.57
Generic share100% of claims

Medicare sources and data years

Education and affiliations

Graduation year2020
Medicare specialtyPhysician Assistant

Medical group

Hospital affiliation

Source: CMS Care Compare

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Physician Assistant providers in Port Jefferson

All Physician Assistant providers in New York →