Paul Michael Domanchuk, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

8073T Issued in CA

Practice address

616 H St
Eureka, CA 95501-1026

Phone

(707) 443-1619

NPI assigned

Apr 10, 2006

Last updated

Nov 21, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1548223571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 H ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011026",
            "telephone_number": "707-443-1619",
            "fax_number": "707-443-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 H ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011026",
            "telephone_number": "707-443-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMANCHUK",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "8073T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0080730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Lee Dodds
• Carolyn Doering
• Dolbeer St Medical Services a Medical Corporation
• Burton Dollarhide, RN
• Nichole Dollarhide, PPS, LEP
• Cecilie-Joy L Domingo
• Rachel Donohue, MD
• Kelsey Donovan
• Jessica Dora, AMFT
• Louise Dorgan, RN

• Corneal and Contact Management Optometrist in Eureka, CA
• Providers in Eureka, CA by specialty
• Corneal and Contact Management Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.