Mark Dedomenico
General Practice • Bellevue, WA
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mark Dedomenico has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Mark Dedomenico was a registered General Practice practicing in Bellevue, WA. Throughout an active medical career spanning 13 years, Mark Dedomenico provided care at the practice location at 4455 148TH AVE NE until profile deactivation on 2025-02-20.
Practice Location & Contact Primary Location
4455 148th Ave Ne
Bellevue, WA 980073120
Specialty Benchmarks & Practice Insights
Comparative analytics for General Practice in Bellevue, WA
Practicing in Bellevue, WA (423 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 208D00000X
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Physical Medicine & Rehabilitation
Physical Therapist, Doctor of Physical Therapy
Physical Therapist
Physical Therapist
Physical Therapist
Dietitian, Registered
Registered Dietitian
Physical Therapist
Doctor of Physical Therapy
Dietitian, Registered
Registered Dietitian
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on February 20, 2025
General Practice (License #MD00011381 in WA)
NPI status registered as active in NPPES database
Registered at 4455 148TH AVE NE, BELLEVUE, WA 980073120 (Tel: 4258675175)
Registered at 4455 148TH AVE NE, BELLEVUE, WA 980073120
Recorded as MARK DEDOMENICO
General Practice (License #MD00011381 in WA)
First registered as active Individual Practitioner in NPPES Database.
Patient & Community Reviews
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NPI Administrative Meta
Mailing Address
4455 148th Ave Ne
Bellevue, WA 980073120
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