Tamara Domazet, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19564 Issued in MN

Practice address

152 River Woods LN
Burnsville, MN 55337-3322

Phone

(507) 334-1983

Fax

(507) 333-2307

NPI assigned

Aug 8, 2011

Sex

Female

Sole proprietor

No

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 MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cedar House IncGroup PAC ID 8729975479, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cedar House Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Faribault, MN
  • NPI 1952321424
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1811276819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 RIVER WOODS LN",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553373322",
            "telephone_number": "507-334-1983",
            "fax_number": "507-333-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 RIVER WOODS LN",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553373322",
            "telephone_number": "507-334-1983",
            "fax_number": "507-333-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAZET",
        "first_name": "TAMARA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MINNESOTA BOARD OF SOCIAL WORK",
            "identifier": "19564",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dispatchhealth-Arizona
• Ainsley Grace Ditlefsen
• Doctor Etyane Ayana
• Alexander J Dodd
• Kristin Anne Dolby, OTRL
• Dominion, Inc.
• Joyce Domogalla
• Briana Rae Donald, PA-C
• Jessie Christine Donovan, PA-C
• Haimlawattie Doobay

• Clinical Social Worker in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.