Individual provider Active NPI

Tamara Domokos

  • Adult Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1912782665
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311276 Issued in NY
Practice address
1870 Winton Rd S
Rochester, NY 14618-3960
Phone
(585) 442-4690
Fax
(585) 385-9124
NPI assigned
Aug 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311276 NY Primary

Addresses

Primary practice location

1870 Winton Rd S
Rochester, NY 14618-3960

Mailing address

1870 Winton Rd S Ste 1
Rochester, NY 14618-3960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125000237 NY Practitioner - Nurse Practitioner 0446603559 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
311276NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westfall Cardiology PLLC CurrentSince Nov 29, 2023 Accepting new patients

Locations

1100 Driving Park Ave
Newark, NY 14513
Phone (315) 331-4344

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1870 Winton Rd S
Ste 1
Rochester, NY 14618
Phone (585) 442-4690

Interoperability endpoints

  • Direct secure messaging: tdomokos@westfallcardiology.medentdirect.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1912782665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 WINTON RD S STE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 WINTON RD S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183960",
            "telephone_number": "585-442-4690",
            "fax_number": "585-385-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMOKOS",
        "first_name": "TAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.