Fernando B Domondon Jr., MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

196197 Issued in NY

Practice address

S 3669 Southwestern Blvd
Mercy Ambulatory Care Center
Orchard Park, NY 14127

Phone

(716) 204-4500

Fax

(716) 204-4501

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Buffalo Emergency Associates LLP

  • Emergency Medicine Physician
  • Williamsville, NY
  • NPI 1508816521
  Medicare reassignment NPD
• Western New York Immediate Medical Care LLC

  dba WNY Immediate Care

  • Urgent Care Clinic/Center
  • Williamsville, NY
  • NPI 1316014491
  NPD
• Western New York Immediate Medical Care LLC

  • Emergency Medicine Physician
  • Orchard Park, NY
  • NPI 1427224625
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1013969492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6653 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215906",
            "telephone_number": "716-204-4500",
            "fax_number": "716-204-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S 3669 SOUTHWESTERN BLVD",
            "address_2": "MERCY AMBULATORY CARE CENTER",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "14127",
            "telephone_number": "716-204-4500",
            "fax_number": "716-204-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMONDON",
        "first_name": "FERNANDO",
        "middle_name": "B",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "196197-1",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "196197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01610939",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Mark Dolgos, DDS
• Sarah Marie Dolph
• Lisa Domagala, RPA-C
• Cheryl Lynn Domanick, R.PH.
• Jacqueline A Dombrowski, MD
• Jaclyn M Domroes, PA
• Jessica Anne Dorsey, L.M.T.
• James Robert Dossett, D.C.
• Double Talk - Bilingual Speech Therapy Services
• Double Talk, LLC

• Emergency Medicine Physician in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.