Individual provider Active NPI

Domenique Martini, APRN

  • Family Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1083205538
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11011433 Issued in FL
Practice address
2500 Harbor Blvd
Port Charlotte, FL 33952-5000
Phone
(941) 766-4564
NPI assigned
Jan 28, 2021
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11011433 FL
Family Nurse Practitioner 363LF0000X APRN11011433 FL Primary
Registered Nurse 163W00000X RN9385530 FL

Addresses

Primary practice location

2500 Harbor Blvd
Port Charlotte, FL 33952-5000

Mailing address

1012 N Mills Ave
Arcadia, FL 34266-8811
Phone (941) 206-0325

Other practice location 1

1012 N Mills Ave
Arcadia, FL 34266-8811
Phone (941) 206-0325

Other identifiers 1

IdentifierTypeStateIssuer
119200400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230911003213 FL Practitioner - Nurse Practitioner 2567826456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

2500 Harbor Blvd
Port Charlotte, FL 33952-5000
Phone (941) 766-4903

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
77.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9385530FLMDRegistered Nurse
11011433FLMDNurse Practitioner
APRN11011433FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Port Charlotte Hma Physician Management LLC CurrentSince Aug 7, 2023 Accepting new patients
Florida Hospital Physician Group Inc Nurse Practitioner CurrentSince May 22, 2025 Accepting new patients
Port Charlotte Hma Physician Management LLC CurrentSince Aug 7, 2023 Accepting new patients

Locations

1012 N Mills Ave
Arcadia, FL 34266
Phone (863) 494-2663

2521 Del Prado Blvd N
Cape Coral, FL 33909
Phone (239) 242-1357

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

1641 Tamiami Trl
Ste 2
Pt Charlotte, FL 33948
Phone (941) 255-3499

2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dmartini4497438@adventhealth.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1083205538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 N MILLS AVE",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668811",
            "telephone_number": "941-206-0325",
            "fax_number": "941-766-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HARBOR BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525000",
            "telephone_number": "941-766-4564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 N Mills Ave",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668811",
            "country_code": "US",
            "telephone_number": "941-206-0325",
            "fax_number": "941-766-1009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINI",
        "first_name": "DOMENIQUE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11011433",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011433",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9385530",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119200400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.