Michael William Dominisse, PA

Physician assistant in Fort Worth, Texas · NPI 1962914580

Michael Dominisse is one of 509 physician assistants practicing in Fort Worth, Texas. Michael Dominisse practices with Molly M Warthan MD.

Registry record (NPPES)

NPI
1962914580
Type
Type 1 · Individual
Primary taxonomy
Physician Assistant · 363A00000X
Address on file
5751 Edwards Ranch Rd Ste 101
Fort Worth, TX 76109-4131
(817) 923-8220
Enumerated
Nov 5, 2017
Record last updated
Feb 23, 2026
License states listed
NULL

Medicare (CMS)

Enrollment
Medicare-enrolled in TX
Physician Assistant
Revalidation due
No date set by CMS

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  • Part D prescribing
  • Procedure volumes by CPT code
  • Group affiliations and colleagues
  • Full enrollment history
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Practice locations

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Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.