Jacob Domoracki, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

SP028313 Issued in PA

Practice address

232 W 25TH St
Erie, PA 16544-0001

Phone

(814) 452-5000

NPI assigned

Jul 14, 2023

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 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Vincent Consultants in Cardiovascular DiseasesGroup PAC ID 7214124221, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

Merit-based Incentive Payment System (MIPS)

Final score

93.9 of 100Reported as apm

Quality

85.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdomoracki149922@direct.ahn.org

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.

• Saint Vincent Consultants in Cardiovascular Diseases

  • Cardiovascular Disease Physician
  • Erie, PA
  • NPI 1902114911
  Medicare reassignment Care Compare group NPD
• St Vincent Medical Education and Research Institute Inc

  • Internal Medicine Physician
  • Erie, PA
  • NPI 1902881477
  NPD (past)

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

• Saint Vincent Health Center

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1861435042
  Care Compare affiliation

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1245919448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 BROAD ST",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440301710",
            "telephone_number": "216-882-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 W 25TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165440001",
            "telephone_number": "814-452-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2315 Myrtle St Ste 190",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165024604",
            "country_code": "US",
            "telephone_number": "814-453-7767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMORACKI",
        "first_name": "JACOB",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-11-07",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "PA",
            "license": "RN670780",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP028313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "RN670780",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED REGISTERED NURSE PRACTITIONER - ADULT-GERONTOLOGY ACUTE CARE",
            "identifier": "SP028313",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Andrew Doleski, D.M.D., M.S.
• Jessica K Dombkowski, LPC
• Kristin Ann Dombroski, LCSW
• Colleen Kassandra Dominici, PA-C
• Tim Dommermuth, R.PH.
• Michelle M. Domowicz, M.A., L.PSY
• Christina M Donath, MD
• Claire Donch, LCSW
• Siyi Dong
• Mary Donikowski, CRNP

• Acute Care Nurse Practitioner in Erie, PA
• Providers in Erie, PA by specialty
• Acute Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.
• 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.