DANA DOMANSKI-MCNULTY (FNP-C) – Family Nurse Practitioner, NPI 1760070635

DANA DOMANSKI-MCNULTY (FNP-C) is a healthcare provider. based in Southgate, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 4704270401 (MI). The NPI Number for DANA DOMANSKI-MCNULTY (FNP-C) is 1760070635

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DANA DOMANSKI-MCNULTY (FNP-C)
NPI
1760070635
Phone
(734) 282-5444
Address
15830 FORT ST
Enumeration Date
6 January 2021
Last Update Date
9 May 2022

Doctor Profile

Medical School Name
SIOUX CITY COLLEGE OF MEDICINE
Secondary Phone
7342825444
Graduation Year
2020 (6 years ago)
PAC ID
1355704792
Group Practice PAC ID
9537575881
Professional Enrollment ID
I20230831003454
Address ID
MI481951367SO15830STXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

Provider Addresses for DANA DOMANSKI-MCNULTY (FNP-C)

  • 15830 FORT ST

    SOUTHGATE, MI 481951367

    Phone: (734) 282-5444

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230831003454INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48195)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537575881View full group profile
NameSpecialtyState
Nurse PractitionerMI

Reviews

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Frequently asked questions

What unique ID ties claims to DANA DOMANSKI-MCNULTY (FNP-C)?
NPI 1760070635 is assigned to DANA DOMANSKI-MCNULTY (FNP-C) under the national enumeration system.
Is DANA DOMANSKI-MCNULTY (FNP-C) currently active in the NPI registry?
CMS-published data lists DANA DOMANSKI-MCNULTY (FNP-C) as an active registrant.
Can you summarize DANA DOMANSKI-MCNULTY (FNP-C)'s specialty in plain language?
Clinically, the directory lists DANA DOMANSKI-MCNULTY (FNP-C) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is DANA DOMANSKI-MCNULTY (FNP-C)'s primary listing?
We display Southgate, Michigan because that is what the record indicates for DANA DOMANSKI-MCNULTY (FNP-C).
How can I contact DANA DOMANSKI-MCNULTY (FNP-C)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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