Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dominic Lullo, MD

Individual provider Surgery Physician · NPI 1598227415

Dominic Lullo, MD is a General Surgery in Mesa, Arizona. Qualified in 2019, 7 years ago. Practices with Banner Hospital Based Physicians Arizona LLC, a 641-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
7
Licensed in
AZ
In the registry since
2019
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2945 S Dobson Rd
Mesa, AZ 85202-7941
Phone: (480) 969-4138
Fax: (480) 969-0630
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 77760 (AZ)

Record details

NPI number1598227415
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 1, 2019
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Banner Hospital Based Physicians Arizona Llc — 641 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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