Timothy Domer, M.D.

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

23789 Issued in AZ

Practice address

1601 W Saint Marys Rd
Tucson, AZ 85745-2623

Phone

(520) 872-6040

Fax

(520) 872-6007

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Tedomer LLC

  • Internal Medicine Physician
  • Gallup, NM
  • NPI 1033394861

  Geriatric Medicine

  NPD (past) Authorized official
• DHHS PHS Naihs Fort Defiance Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1700962131
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1942389770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 N FORBES BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451412",
            "telephone_number": "520-872-7536",
            "fax_number": "520-872-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W SAINT MARYS RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452623",
            "telephone_number": "520-872-6040",
            "fax_number": "520-872-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMER",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "23789",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "AZ",
            "license": "23789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407678",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kira M Doll, DPT
• Meghan Alexa Dolly, PHARMD
• Denei Karee Dolman, WHNP-BC
• Dolores Home LLC
• Nola Domenici, LPC
• Olivia Domingo
• Danielle Dominguez, RDN
• Eduardo Dominguez
• Fernando Dominguez, DPT
• Jose Felipe Dominguez

• Hospice and Palliative Medicine (Internal Medicine) Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.