Dominick Joseph Acquaro, DO
Individual provider Active NPI Family Medicine Physician · Fort Wayne, IN
NPI 1366930737 · NPPES record last updated Oct 13, 2024
Key facts
- NPI
- 1366930737
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 02006542A (IN)
- Practice address
- 7806 W Jefferson Blvd Ste E
Fort Wayne, IN 46804-4180 - Phone
- (260) 459-0087
- Fax
- (260) 969-8514
- NPI assigned
- May 1, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
-
Dominick Acquaro, M.D.
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Marian University College of Osteopathic Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Acquaro Medical Practice, PC
Practice addresses (Care Compare)
7806 W Jefferson Blvd
Suite E
Fort Wayne, IN 46804-4180
Phone (260) 459-0087
Hospital & facility affiliations
- Parkview Regional Medical Center
- Lutheran Hospital of Indiana
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230302001853 | IN | Practitioner - Family Practice |
0749535458 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02006542A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acquaro Medical Practice, PC | Family Medicine | Current |
Accepting new patients |
Locations
7806 W Jefferson Blvd
Ste E
Fort Wayne, IN 46804
Phone (260) 459-0087
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 02006542A | IN | Yes |
Addresses
Primary practice location
7806 W Jefferson Blvd Ste E
Fort Wayne, IN 46804-4180
Mailing address
7806 W Jefferson Blvd Ste E
Fort Wayne, IN 46804-4180
Phone (260) 459-0087
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Other | IN | STATE LICENSE |
Other providers in Fort Wayne, IN
- Rebeca G Ackermann
- Denise Calixta Acosta
- Kierra A Acosta
- Acquaro Medical Practice, PC
- Dominick Acquaro
- Gabrielle Paloma Acquaro
- Acss, LLC
- Act 3 Care LLC
- Active Physical Therapy and Wellness LLC
- Acupuncture and Wellness Center, LLC
All providers in Fort Wayne, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.