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

Mikhail V Domnine, PA

Individual provider Physician Assistant · NPI 1659453454

Mikhail V Domnine, PA is a Physician Assistant in Germantown, Maryland. Qualified in 2001, 25 years ago. Practices with Centers for Advanced ENT Care LLC, a 103-clinician group and accepts Medicare assignment. Licensed in Maryland, North Carolina and Pennsylvania.

Years since qualifying
25
Licensed in
MD, NC, PA
In the registry since
2006
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

12850 Middlebrook Rd Ste 410
Germantown, MD 20874-5281
Phone: (301) 652-8847
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C0009827 (MD)
Physician Assistant Taxonomy 363A00000X · Licence MA052604 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 001001114 (NC)

Record details

NPI number1659453454
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 20, 2006
Last updated in NPPESJuly 29, 2025
Certification dateJuly 29, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Centers For Advanced Ent Care Llc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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