| Dominique Caporusso, PA-C | |
|
650 Sprucewood Ln, Erlanger, KY 41018-1062 | |
| (859) 282-6600 | |
| Not Available |
| Full Name | Dominique Caporusso |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 7 Years |
| Location | 650 Sprucewood Ln, Erlanger, Kentucky |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225697329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | TC835 (Kentucky) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Complexcare Medical Group Midwest M Pllc | 1355858630 | 87 |
| Entity Name | CG Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982903951 PECOS PAC ID: 6608052196 Enrollment ID: O20110518000216 |
| Entity Name | Complexcare Medical Group Midwest M PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528851607 PECOS PAC ID: 1355858630 Enrollment ID: O20250819001725 |
| Mailing Address | Practice Location Address |
|---|---|
| Dominique Caporusso, PA-C 22 Casagrande St, Fort Thomas, KY 41075-4023 Ph: (859) 512-7050 | Dominique Caporusso, PA-C 650 Sprucewood Ln, Erlanger, KY 41018-1062 Ph: (859) 282-6600 |
Daniel Lee Mullins, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1825 Airport Exchange Blvd Ste 100, Erlanger, KY 41018 Phone: 859-647-6228 Fax: 859-372-6350 |
Ms. Jillian Benson, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 600 Rodeo Dr Ste A, Erlanger, KY 41018 Phone: 513-354-3700 |