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

Dominic Moore

Individual provider Physician Assistant · NPI 1518542810

Dominic Moore is a Physician Assistant in Burnsville, Minnesota. Qualified in 2023, 3 years ago. Practices with Sunny S Kim MD PA, a 4-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida and Minnesota.

Years since qualifying
3
Licensed in
FL, MN
In the registry since
2021
Specialties on file
3
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Practice location Address checks out

1601 Highway 13 E
Burnsville, MN 55337-6865
Phone: (952) 405-9760
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 20635 Kuykendahl Rd, Spring, TX 77379-3533 — (952) 405-9760

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14579 (MN)
Physician Assistant Taxonomy 363A00000X · Licence 1208270 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1518542810
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 17, 2021
Last updated in NPPESMarch 2, 2026
Certification dateMarch 2, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Sunny S Kim Md Pa — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Burnsville