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

MS. Ewelina Domanowski

Individual provider Physician Assistant · NPI 1124633169

MS. Ewelina Domanowski is a Physician Assistant in Port Jefferson, New York. Qualified in 2020, 6 years ago. Practices with John T Mather Memorial Hospital, a 180-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2020
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Practice location Address checks out

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone: (631) 473-1320
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1124633169
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 15, 2020
Last updated in NPPESAugust 15, 2023
Certification dateAugust 15, 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 John T Mather Memorial Hospital — 180 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Port Jefferson