Alain Lesage Fondjo Domkam, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

19760 Issued in MS

Practice address

302 8TH St
Greenwood, MS 38930-4014

Phone

(662) 451-4570

Fax

(662) 451-5140

NPI assigned

May 29, 2007

Last updated

Oct 25, 2024By 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

Medicare fee-for-service enrollment

Enrolled in MS, GA, CO, MO, MI5 enrollments

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 5

Specialty

Vascular Surgery

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Center for Podiatry CareGroup PAC ID 8022048222, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
• HCA Florida Bayonet Point Hospital Hospital, Hudson, FL, CCN 100256

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aiyandiabetescenter.alaindomkam-fondj@156247.advancedmd-direct.com
• Direct secure messaging: alain.domkam@scs-direct.glh.org

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.

• Center for Podiatry Care

  dba Aiyan Diabetes Center

  • Podiatrist
  • Martinez, GA
  • NPI 1174695357

  Vascular Surgery

  Medicare reassignment Care Compare group NPD
• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490
  Medicare reassignment Care Compare group
• Vicksburg Healthcare LLC

  dba River Region Health System

  • Anesthesiology Physician
  • Vicksburg, MS
  • NPI 1629084058
  Medicare reassignment NPD
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  Medicare reassignment NPD
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment NPD
• USA Vascular Center of Decatur LLC

  • Vascular Surgery Physician
  • Decatur, GA
  • NPI 1487133278
  Medicare reassignment NPD
• USA Vein Clinics of Decatur LLC

  • Vascular Surgery Physician
  • Decatur, GA
  • NPI 1912301003
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  dba UMMC Greenwood Hospital

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  NPD
• Vicksburg Healthcare LLC

  dba Merit Health River Region

  • General Acute Care Hospital
  • Vicksburg, MS
  • NPI 1215981303
  NPD
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD

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

• HCA Health Services of Florida, Inc.

  dba HCA Florida Bayonet Point Hospital

  • General Acute Care Hospital
  • Hudson, FL
  • NPI 1992759419
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center Midland

  dba Family Practice Center

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1376973149
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1902841414
  Care Compare affiliation

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1962603886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 8TH ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304014",
            "telephone_number": "662-451-4570",
            "fax_number": "662-451-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 8TH ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304014",
            "telephone_number": "662-451-4570",
            "fax_number": "662-451-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONDJO DOMKAM",
        "first_name": "ALAIN",
        "middle_name": "LESAGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MS",
            "license": "19760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Henry Flautt Jr., M.D.
• Ayla Fletcher, PCMT
• Belinda Fletcher
• Floral Optix, LLC
• Kerrin A. Flowers, FNP-BC
• Rosie Denice Fort Brownlow
• David Franklin, CRNA
• Fredrick J Bradshaw MD & Joyce J Bradshaw MD Inc
• Freds Pharmacy 1736
• Hillary Freeman, PHARMD

• Vascular Surgery Physician in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Vascular Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.