Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dominic Bogucki, ATC, PA-C

Individual provider Athletic Trainer · NPI 1265970669

Dominic Bogucki, ATC, PA-C is a Physician Assistant in Norristown, Pennsylvania. Qualified in 2020, 6 years ago. Practices with Einstein Practice Plan Inc, a 764-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
6
Licensed in
PA
In the registry since
2017
Specialties on file
2
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

170 W Germantown Pike
Norristown, PA 19401-1389
Phone: (215) 605-3634
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence MA064456 (PA)
Athletic Trainer Taxonomy 2255A2300X (PA)

Record details

NPI number1265970669
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC , PA-C
Sole proprietorNo
NPI enumeratedFebruary 6, 2017
Last updated in NPPESDecember 6, 2023
Certification dateDecember 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Einstein Practice Plan Inc — 764 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in Norristown