{"npi":"1942380902","type":"NPI-1","status":"active","name":{"display":"Louis Domenico MD","other":[],"first":"LOUIS","last":"DOMENICO","credential":"MD"},"specialty":{"primary_taxonomy":"2085R0204X","primary_taxonomy_description":"Vascular & Interventional Radiology Physician","slug":"vascular-interventional-radiology-physician","schema_org_specialty":null,"all":[{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"PA","license":"MD426532"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"NJ","license":"25MA08328500"},{"code":"2085R0204X","description":"Vascular & Interventional Radiology Physician","primary":false,"state":"NJ","license":"25MA08328500"},{"code":"2085R0204X","description":"Vascular & Interventional Radiology Physician","primary":true,"state":"PA","license":"MD426532"}]},"addresses":[{"purpose":"LOCATION","street_1":"2412-14 WEST PASSYUNK AVENUE","city":"PHILADELPHIA","state":"PA","postal_code":"191454114","country_code":"US","phone":"2154622100","fax":"2154623100"},{"purpose":"MAILING","street_1":"PO BOX 416147","city":"BOSTON","state":"MA","postal_code":"022416147","country_code":"US","phone":"6106448900","fax":"4849240053"}],"license":{"state":"PA","number":"MD426532"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"0157562","state":"NJ","issuer":null},{"type_code":"01","label":"Other","value":"P00823218","state":"NJ","issuer":"RAILROAD MEDICARE"},{"type_code":"05","label":"Medicaid","value":"1017778250003","state":"PA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20061221000007","type_code":"14-94","type_desc":"PRACTITIONER - INTERVENTIONAL RADIOLOGY","state":"PA","pac_id":"7113953415"}]},"enumeration_date":"2006-10-16","last_updated":"2021-02-18","_meta":{"source":"NPPES","snapshot_date":"2021-02-18","doc_url":"https://findmynpi.com/api"}}