Individual provider Active NPI

Patrick W Domkowski, MD

  • Surgery Physician
  • Melbourne, FL
National Provider Identifier
1366423022
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME89469 Issued in FL
Practice address
2222 S Harbor City Blvd Ste 430
Melbourne, FL 32901-5591
Phone
(321) 344-8746
Fax
(321) 339-1932
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME89469 FL Primary

Addresses

Primary practice location

2222 S Harbor City Blvd Ste 430
Melbourne, FL 32901-5591

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 344-8746

Other practice location 1

1810 Eldron Blvd SE
Palm Bay, FL 32909-6831
Phone (321) 344-8746

Other identifiers 8

IdentifierTypeStateIssuer
122937200MedicaidFL
3456730OtherFLAETNA
37840OtherFLBLUE CROSS BLUE SHIELD
P00217825OtherFLRAILROAD MEDICARE
239538OtherFLWELLCARE
6039513001OtherFLCIGNA
7801535OtherFLAETNA
XG958OtherFLHFMG

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624001122 FL Practitioner - General Surgery 9436135118 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles (7 of 9)

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc. Surgery CurrentSince May 1, 2017 Accepting new patients
Steward Medical Group, Inc CurrentSince May 1, 2017 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
Sebastian Hma Physician Management LLC Past Accepting new patients
Omni Healthcare, Inc. Past Accepting new patients
Stewart and Stewart a Medical Corporation PastSince Apr 27, 2025 Accepting new patients

Locations

2222 S Harbor City Blvd
Ste 430
Melbourne, FL 32901
Phone (321) 541-1777

2290 W Eau Gallie Blvd
Melbourne, FL 32935
Phone (321) 254-4776

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

14430 US Highway 1
Ste 101
Sebastian, FL 32958
Phone (772) 581-0478

13840 US Highway 1
Sebastian, FL 32958
Phone (772) 581-0334

8000 Ron Beatty Blvd
Ste A-3
Sebastian, FL 32976
Phone (772) 664-1388

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: patrick.domkowski.1@15594.direct.athenahealth.com

Organizations & group practices 11

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 5

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

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group Inc 2,171 clinicians
Health First Medical Group, LLC 701 clinicians

Practice addresses (Care Compare)

14430 US Hwy 1
Suite 101
Sebastian, FL 32958-3289
Phone (772) 581-8003

699 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3562

8745 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-5162

Hospital & facility affiliations

  • Pinnacle Home Care Home health agency, Port Saint Lucie, FL, CCN 109610
  • Mederi Caretenders Home health agency, Vero Beach, FL, CCN 107036
  • Activa Home Health Home health agency, Stuart, FL, CCN 108113
  • Orlando Health Sebastian River Hospital Hospital, Sebastian, FL, CCN 100217

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux29
Removal of tissue1-10

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1366423022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-344-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S HARBOR CITY BLVD STE 430",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015591",
            "telephone_number": "321-344-8746",
            "fax_number": "321-339-1932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1810 Eldron Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329096831",
            "country_code": "US",
            "telephone_number": "321-344-8746",
            "fax_number": "321-339-1932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMKOWSKI",
        "first_name": "PATRICK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME89469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122937200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3456730",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "37840",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00217825",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "239538",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6039513001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7801535",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HFMG",
            "identifier": "XG958",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.