Regina M Dorman, M.D.
Individual provider Active NPI Family Medicine Physician · Tallmadge, OH
NPI 1699765404 · NPPES record last updated Nov 30, 2017
Key facts
- NPI
- 1699765404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35071289 (OH)
- Practice address
- 65 Community Rd
Suite C
Tallmadge, OH 44278-2357 - Phone
- (330) 633-6601
- Fax
- (330) 630-2941
- NPI assigned
- Oct 24, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pioneer Physicians Network Inc
Practice addresses (Care Compare)
65 Community Rd
Suite C
Tallmadge, OH 44278-2358
Phone (330) 633-6601
Hospital & facility affiliations
- Summa Health System
- Akron General Medical Center
- Summa Western Reserve Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- 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 |
|---|---|---|---|---|
| I20060109000669 | OH | Practitioner - Family Practice | 7618957325 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pioneer Physicians Network, Inc. | Family Medicine | Current |
Accepting new patients |
| Pioneer Physicians Network Inc | Family Medicine | Current |
Accepting new patients |
Locations
3515 Massillon Rd
Ste 300
Green, OH 44685
Phone (234) 271-3353
3300 Greenwich Rd
Unit 8
Norton, OH 44203
Phone (330) 825-7371
65 Community Rd
Ste F
Tallmadge, OH 44278
Phone (330) 633-3680
65 Community Rd
Ste C
Tallmadge, OH 44278
Phone (330) 633-6601
65 Community Rd
Tallmadge, OH 44278
Phone (330) 633-3680
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BBBCAA
- regina.dorman@ppn.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35071289 | OH | Yes |
Addresses
Primary practice location
65 Community Rd
Suite C
Tallmadge, OH 44278-2357
Mailing address
3515 Massillon Rd
Suite 300
Uniontown, OH 44685-6400
Phone (330) 899-9350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2042908 | Medicaid | OH |
Other providers in Tallmadge, OH
- Joseph D Deppen
- Chris Derry
- Matthew Dexter
- Jay A Dipaolo
- Michelle Donnelly
- Mary Kay Dotterer
- Antonette Doty
- Rechelle Dougherty
- Savannah Rose Douglas
- Colin James Drolshagen
All providers in Tallmadge, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2017. 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.