SARAH ANNE DOMENICUCCI (PA, ATC) – Physician Assistant, NPI 1245219823
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for SARAH ANNE DOMENICUCCI (PA, ATC)
164 Wetherby Ln
Westerville, OH 430814957
Phone: (614) 839-2300
Fax: (614) 839-2301
Type: Location
303, East Town Street, Discovery District, Columbus, Franklin, Ohio, 43215, United States
COLUMBUS, OH 432154601
Phone: (614) 788-5000
Fax: (614) 788-5100
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $41.
Total Amount is formed as General ($41) + Research ($0) + Ownership ($0) = $41.
Last reported payment date: 2023-09-19 • Largest payer in this snapshot: Ethicon US, LLC ($41).
Total Amount
$41
General + Research + Ownership
Payments
2
Total payment records
General Amount
$41
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ethicon US, LLC | $41 |
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: 2006-02-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060209000415 | I | Physician Assistant | OH | TBD |
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.
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 43081)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Physician Assistant | OH | |
| Internal Medicine, Family Practice, Urology | OH | |
| Physician Assistant | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| - | OH | |
| Internal Medicine, Pulmonary Disease, Critical Care (Intensivists) | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Physician Assistant | OH | |
| General Practice | OH |
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