Individual provider Active NPI

George H Domb, M.D.

  • Otolaryngology Physician
  • Redding, CA
National Provider Identifier
1962426833
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G31077 Issued in CA
Practice address
2125 Court St
Redding, CA 96001-2531
Phone
(530) 242-5600
Fax
(530) 242-5605
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G31077 CA Primary

Addresses

Primary practice location

2125 Court St
Redding, CA 96001-2531

Mailing address

2125 Court St
Redding, CA 96001-2531
Phone (530) 242-5600

Other identifiers 1

IdentifierTypeStateIssuer
00G310770MedicaidCA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080605000454 CA Practitioner - Otolaryngology 0143118059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, Davis School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2125 Court St
Redding, CA 96001-2531
Phone (530) 242-5600

Hospital & facility affiliations

  • Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764
  • Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280
  • Vibra Hospital of Northern California Long-term care hospital, Redding, CA, CCN 052047

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shasta ENT Specialists Otolaryngology CurrentSince Mar 1, 2004 Accepting new patients
Shasta Regional Medical Center, LLC PastSince Jan 1, 2007 Accepting new patients

Locations

2125 Court St
Redding, CA 96001
Phone (530) 242-5600

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1962426833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 COURT ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012531",
            "telephone_number": "530-242-5600",
            "fax_number": "530-242-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 COURT ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012531",
            "telephone_number": "530-242-5600",
            "fax_number": "530-242-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMB",
        "first_name": "GEORGE",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2021-04-15",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G31077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G310770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.