NPIMap

Individual provider Active NPI

Dominik Grzegorz Sokalski, M.D.

  • Rheumatology Physician
  • Medford, OR
National Provider Identifier
1104016278
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD153128 Issued in OR
Practice address
1365 Poplar Dr
Medford, OR 97504-5207
Phone
(541) 773-2233
Fax
(541) 773-7089
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD153128 OR Primary
Rheumatology Physician 207RR0500X 56254 CO

Addresses

Primary practice location

1365 Poplar Dr
Medford, OR 97504-5207

Mailing address

1365 Poplar Dr
Medford, OR 97504-5207
Phone (541) 773-4291

Other identifiers 5

IdentifierTypeStateIssuer
R194430OtherORMEDICARE OR
500722930MedicaidOR
MD153128OtherORSTATE LICENSE
478052ZL1POtherCOMEDICARE CO
DR.0056254OtherCOSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170606002834 OR Practitioner - RheumatologyPractitioner - Internal Medicine 3779747068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rheumatology Clinic LLCGroup PAC ID 1951426303, 3 clinicians

Practice addresses (Care Compare)

1365 Poplar Dr
Medford, OR 97504-5207
Phone (541) 773-2233

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.86 of 100Reported as group
Quality
99.73
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56254COMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David Dryland, PC Rheumatology Current Accepting new patients
Rheumatology Clinic LLC Rheumatology CurrentSince Jun 1, 2017 Accepting new patients
Lawrence Levin MD Inc Rheumatology Current Accepting new patients
David Chamberland MD Inc Rheumatology Current Accepting new patients

Locations

1365 Poplar Dr
Medford, OR 97504
Phone (541) 773-2233

Interoperability endpoints

  • Direct secure messaging: dominiksokalski@rheumatologyclinic.direct.emds.com

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1104016278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 POPLAR DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045207",
            "telephone_number": "541-773-4291",
            "fax_number": "541-773-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 POPLAR DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045207",
            "telephone_number": "541-773-2233",
            "fax_number": "541-773-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOKALSKI",
        "first_name": "DOMINIK",
        "middle_name": "GRZEGORZ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OR",
            "license": "MD153128",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CO",
            "license": "56254",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OR",
            "identifier": "R194430",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500722930",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD153128",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CO",
            "identifier": "478052ZL1P",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DR.0056254",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.