Richard James Domdera Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35077042D Issued in OH

Practice address

3009 Smith Rd
Suite 200
Fairlawn, OH 44333-2666

Phone

(330) 836-8471

NPI assigned

Mar 14, 2006

Last updated

Aug 28, 2012By 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

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in OH

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

Family Practice

Education

Ohio State University College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pioneer Physicians Network IncGroup PAC ID 0648160002, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Summa Home Health and Hospice LLC Home health agency, Akron, OH, CCN 367713
• Akron General Medical Center Hospital, Akron, OH, CCN 360027
• Summa Health System Hospital, Akron, OH, CCN 360020
• Summa Western Reserve Hospital Hospital, Cuyahoga Falls, OH, CCN 360150

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BBBCAA
• Direct secure messaging: richard.domdera@ppn.eclinicaldirectplus.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.

• Pioneer Physicians Network, Inc.

  • Family Medicine Physician
  • Uniontown, OH
  • NPI 1851354633
  Medicare reassignment Care Compare group NPD
• Pioneer Physicians Network Inc

  • Family Medicine Physician
  • Canton, OH
  • NPI 1174296172
  NPD

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

• Akron General Medical Center

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1821035940
  Care Compare affiliation
• Summa Health System

  dba Summa Health System Ignatia Hall South

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Canton, OH
  • NPI 1295036762

  Hospital

  Care Compare affiliation
• Summa Health System

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1396765681
  Care Compare affiliation
• Summa Health System

  • Clinical Medical Laboratory
  • Barberton, OH
  • NPI 1609263706

  Hospital

  Care Compare affiliation
• Summa Home Health and Hospice, LLC

  dba Summa Health at Home

  • Home Health Agency
  • Akron, OH
  • NPI 1013422534
  Care Compare affiliation
• Western Reserve Hospital, LLC

  • General Acute Care Hospital
  • Cuyahoga Falls, OH
  • NPI 1518104199
  Care Compare affiliation

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1891763058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 SMITH RD",
            "address_2": "SUITE 200",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332666",
            "telephone_number": "330-836-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 SMITH RD",
            "address_2": "SUITE 200",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332666",
            "telephone_number": "330-836-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMDERA",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35077042D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "97033",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00121516",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM INSURANCE",
            "identifier": "000000312579",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE INSURANCE",
            "identifier": "374",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOMETOWN INSURANCE",
            "identifier": "Q004524",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2283176",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE COMMUNITY INSURAN",
            "identifier": "729920",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terressa Dixon-Pickett
• Deonna Dixon, LPC
• Nicholas Docs, RN
• Nicholas James Dodds
• Karissa Lynn Dombrowski
• Ryan A Domer, OTD, OTR/L
• Donald a Raabe, DDS, Inc.
• Donich Neurosurgery and Spine, LLC
• Dane J Donich, MD
• Sean Douglas

• Family Medicine Physician in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.