Dominic A Formaro Jr., D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

3843 Issued in IA

Practice address

300 N 4TH Ave E
Ste D
Newton, IA 50208-3155

Phone

(641) 787-3161

Fax

(641) 787-3165

NPI assigned

Jul 16, 2008

Last updated

Mar 29, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

General Surgery

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ottumwa Health Group LLCGroup PAC ID 3971629924, 26 clinicians

Ellsworth Municipal HospitalGroup PAC ID 2668366311, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hansen Family Hospital Hospital, Iowa Falls, IA, CCN 161380
• Ottumwa Regional Health Center Hospital, Ottumwa, IA, CCN 160089

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dominic.formaro.1@6270.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ellsworth Municipal Hospital

  dba Hansen Family Hospital

  • Critical Access Hospital
  • Iowa Falls, IA
  • NPI 1831296052
  Medicare reassignment Care Compare group NPD
• Ottumwa Health Group LLC

  • Gynecology Physician
  • Ottumwa, IA
  • NPI 1386956290
  Medicare reassignment Care Compare group NPD
• Grinnell Regional Medical Center

  dba Unitypoint Health - Grinnell Professional Services

  • Family Medicine Physician
  • Grinnell, IA
  • NPI 1437663242
  Medicare reassignment NPD
• Iowa Physicians Clinic Medical Foundation

  dba UnityPoint Clinic

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  Surgery

  Medicare reassignment NPD
• Ellsworth Municipal Hospital

  dba Iowa Falls Clinic

  • Family Medicine Physician
  • Iowa Falls, IA
  • NPI 1043229735
  NPD
• Ellsworth Municipal Hospital

  dba Hansen Family Hospital Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Iowa Falls, IA
  • NPI 1275697039

  Surgery

  NPD
• Ottumwa Health Group LLC

  dba Ottumwa Women's Health Clinic

  • Rural Health Clinic/Center
  • Ottumwa, IA
  • NPI 1336919364
  NPD
• Doctorsnow Walk-in Care, L.C.

  • Family Medicine Physician
  • Altoona, IA
  • NPI 1649394503
  NPD (past)
• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134
  NPD (past)

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

• Ellsworth Municipal Hospital

  dba Hansen Family Hospital

  • Critical Access Hospital
  • Iowa Falls, IA
  • NPI 1831296052
  Care Compare affiliation
• RCHP Ottumwa LLC

  dba Ottumwa Regional Health Center

  • General Acute Care Hospital
  • Ottumwa, IA
  • NPI 1013233741
  Care Compare affiliation

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1740444058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "641-787-3161",
            "fax_number": "641-787-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 4TH AVE E",
            "address_2": "STE D",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083155",
            "telephone_number": "641-787-3161",
            "fax_number": "641-787-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMARO",
        "first_name": "DOMINIC",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "3843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryellen Faircloth, PT
• Jill Fee
• Danielle Lynn Foglesong, PTA
• Foot and Ankle Center PLLC
• Christine Ann Forck
• Tammy Marie Foster-Harban, LMHC
• Kelsey J Frame, PA-C
• Robyn L Friedman, PT
• Frontline Dermatology LLC
• Leighton E. Frost, MD

• Surgery Physician in Newton, IA
• Providers in Newton, IA by specialty
• Surgery Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.