Individual provider Active NPI

Ramona M Domen, CRNA

  • Certified Registered Nurse Anesthetist
National Provider Identifier
1871585547
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
51740 Issued in IL
Practice address
Naval Hospital Guam
Anesthesia Dept
Fpo, AP 96538-0490
Phone
(671) 344-9304
NPI assigned
Aug 18, 2005
Last updated
Apr 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 51740 IL Primary

Addresses

Primary practice location

Naval Hospital Guam
Anesthesia Dept
Fpo, AP 96538-0490

Mailing address

184 Juan M Cruz Dr
Santa Rita, GU 96915-1743
Phone (671) 344-9386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140415000288 GU Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385876903 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hafa Specialist Group LLPGroup PAC ID 3779482286, 7 clinicians

Practice addresses (Care Compare)

280 Pale San Vitores Rd
Tamuning, GU 96913-3615
Phone (671) 647-4542

Merit-based Incentive Payment System (MIPS)

Final score
88.81 of 100Reported as group
Quality
83.57
Improvement activities
40
Cost
76.16

Merit-based Incentive Payment System (MIPS)

Final score
65.1 of 100Reported as group
Quality
100
Promoting interoperability
0
Improvement activities
30
Cost
79.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51740ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hafa Specialist Group LLP CurrentSince Sep 1, 2020 Accepting new patients
Guam Memorial Hospital CurrentSince Sep 15, 2016 Accepting new patients
Guam X-Ray CurrentSince Jun 19, 2018 Accepting new patients
Hafa Adal Specialist Group, LLP CurrentSince Sep 1, 2020 Accepting new patients
Guam Memorial Hospital CurrentSince Sep 15, 2016 Accepting new patients

Locations

280 Pale San Vitores Rd
Tamuning, GU 96913
Phone (671) 647-4542

633 Gov Carlos G Camacho Rd
Ste 101
Tamuning, GU 96913
Phone (671) 646-3855

633 Gov Carlos G Camacho Rd
Ste 210
Tamuning, GU 96913
Phone (671) 649-1001

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1871585547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 JUAN M CRUZ DR",
            "city": "SANTA RITA",
            "state": "GU",
            "postal_code": "969151743",
            "telephone_number": "671-344-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "NAVAL HOSPITAL GUAM",
            "address_2": "ANESTHESIA DEPT",
            "city": "FPO",
            "state": "AP",
            "postal_code": "965380490",
            "telephone_number": "671-344-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMEN",
        "first_name": "RAMONA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "51740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.