Dominique Mesidor, MD

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

044539 Issued in GA

Practice address

2010 59TH St W
Suite 2200
Bradenton, FL 34209-4616

Phone

(941) 794-5621

Fax

(941) 761-1532

NPI assigned

Oct 5, 2006

Last updated

Nov 1, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI, GA2 enrollments

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 2

Specialty

Critical Care (Intensivists)

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223
• Mercy Health System Corp Hospital, Janesville, WI, CCN 520066

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmesidor189485@orlandohealth.medalliesdirect.net

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

• Mercy Health System Corporation

  dba MHS Physician Services

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment Care Compare group NPD
• St. Francis Physician Practices LLC

  dba St. Francis Primary Care

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1326749417
  Medicare reassignment NPD
• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD
• Mercy Health System Corporation

  dba Mercy Walworth Hospital and Medical Center

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD
• St Francis Physician Practices LLC

  dba St Francis Hospital Intensivists

  • Internal Medicine Physician
  • Columbus, GA
  • NPI 1780059121
  NPD
• St. Francis Physician Practices LLC

  • Gastroenterology Physician
  • Columbus, GA
  • NPI 1609655646
  NPD
• Ernst E. Vieux, Jr., M.D., P.a.

  • Trauma Surgery Physician
  • St Petersburg, FL
  • NPI 1154371714
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Walton Beach Medical Center, Inc.

  dba HCA Florida Fort Walton-Destin Hospital

  • General Acute Care Hospital
  • Fort Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation
• Mercy Health System Corporation

  dba Mercy Hospital Janesville

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  Care Compare affiliation

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1033205091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 59TH ST W",
            "address_2": "SUITE 2200",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094616",
            "telephone_number": "941-794-5621",
            "fax_number": "941-761-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 59TH ST W",
            "address_2": "SUITE 2200",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094616",
            "telephone_number": "941-794-5621",
            "fax_number": "941-761-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESIDOR",
        "first_name": "DOMINIQUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "GA",
            "license": "044539",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "ME0086398",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "U1254X",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267667200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merritt Nutrition LLC
• Jennie Merritt, RDN
• Kathleen Marie Merritt, M.A.
• Nathalia Mesa, M.D.
• Mesaesthetics & Wellness LLC
• David Vincent Messer, P.A.
• Rene Joseph Messier III, APRN FP-C
• Matthew Joseph Messina
• Sarah Messina
• Mester Chiropractic Office PA

• Surgical Critical Care Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Surgical Critical Care Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.