GREGORY S DOMER M.D. NPI 1003872474

Surgery (Vascular Surgery) in Upland, PA

About GREGORY DOMER

Gregory Domer is a provider in Upland, PA with more than 24 years of experience. The NPI number assigned to this provider is 1003872474. The practitioner's primary taxonomy code is Surgery (2086S0129X). The provider is registered as an individual and their NPI record was last updated one year ago. Gregory Domer is registered with Medicare and accepts claims assignment.

NPI1003872474 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name GREGORY S DOMER M.D.
Provider Location AddressONE MEDICAL CENTER BLVD SUITE 233 UPLAND, PA 19013 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address16 ATLANTIC AVE FL 2 LYNBROOK, NY 11563 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Medical School NameOTHER
Graduation Year1994
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date04-25-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date09-15-2016 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

GREGORY S DOMER M.D.
ONE MEDICAL CENTER BLVD
SUITE 233
UPLAND, PA
ZIP 19013
Phone: (610) 499-0400
Fax: (610) 499-1970
Get Directions

Mailing Address

GREGORY S DOMER M.D.
16 ATLANTIC AVE
FL 2
LYNBROOK, NY
ZIP 11563
Phone: (516) 593-1380

Primary Taxonomy

Taxonomy Code2086S0129X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationSurgery
TypeAllopathic & Osteopathic Physicians
SpecializationVascular Surgery
License No.25MA07250800
License StateNJ
Taxonomy DescriptionA surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
12086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryMD427177PANo

Taxonomy Description: a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
101443016 0001MEDICAID (05)PA
H86657MEDICARE UPIN (02)PA
097101 URZMEDICARE ID-TYPE UNSPECIFIED (04)PA

Map Location


GREGORY S DOMER M.D. address is ONE MEDICAL CENTER BLVD SUITE 233 UPLAND, PA 19013

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023014628DR. CALVIN RANDOLPH STAFFORD JR. MD
Individual
Psychiatry & Neurology (Neurology)ONE MEDICAL CENTER BLVD SUITE 533
UPLAND, PA 19013
(610) 619-7475
1053508242 AUBREY S. OKPAKU M.D.
Individual
Neurological SurgeryONE MEDICAL CENTER BLVD SUITE 428
UPLAND, PA 19013
(610) 874-4044
1144290875 MARY LOU PATTON MD
Individual
SurgeryONE MEDICAL CENTER BLVD SUITE 241
CHESTER, PA 19013
(610) 619-7400
1154439461MRS. KIMBERLEE C. GNOINSKI P.A.-C.
Individual
Physician AssistantONE MEDICAL CENTER BLVD CCMC, POB II, SUITE 324
UPLAND, PA 19013
(610) 876-0347
1164584769DR. RICHARD C MELTZ DO
Individual
Obstetrics & GynecologyONE MEDICAL CENTER BLVD SUITE 333
UPLAND, PA 19013
(610) 872-4900
1285693507DR. JOYANN ALLISON KROSER M.D.
Individual
Internal Medicine (Gastroenterology)ONE MEDICAL CENTER BLVD ACP # 231
UPLAND, PA 19013
(610) 619-7475
1285849513 PRAVEENA GANDIKOTA MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)ONE MEDICAL CENTER BLVD SUITE 424
UPLAND, PA 19013
(610) 338-1820
1326185190DR. REGINA TORSNEY-DURKIN M.D.
Individual
Psychiatry & Neurology (Neurology)ONE MEDICAL CENTER BLVD SUITE 533
UPLAND, PA 19013
(610) 874-1184
1346386299DR. ARLIN JOEL SILBERMAN D.O.
Individual
Psychiatry & Neurology (Addiction Psychiatry)ONE MEDICAL CENTER BLVD PSYCHIATRY DEPT, CROZER CHESTER MEDICAL CENTER
UPLAND, PA 19013
(610) 874-5257
1437411352CROZER CHESTER MEDICAL CENTER
Organization
General Acute Care HospitalONE MEDICAL CENTER BLVD ACP 332
UPLAND, PA 19013
(610) 447-7612
1518033125 JUSTIN CHURA M.D.
Individual
Obstetrics & GynecologyONE MEDICAL CENTER BLVD SUITE 441
CHESTER, PA 19013
(610) 876-9640
1538170501 INGRAM M ROBERTS MD
Individual
Internal Medicine (Gastroenterology)ONE MEDICAL CENTER BLVD SUITE 231
UPLAND, PA 19013
(610) 619-7475
1619049517MR. PETER JOHN GUZZETTI RPH
Individual
PharmacistONE MEDICAL CENTER BLVD
UPLAND, PA 19013
(610) 338-8249
1619967908MR. KURT A. MUETTERTIES MD
Individual
Radiology (Diagnostic Radiology)ONE MEDICAL CENTER BLVD
CHESTER, PA 19013
(610) 447-2500
1720058308 LINWOOD R HAITH JR. MD
Individual
SurgeryONE MEDICAL CENTER BLVD SUITE 241
CHESTER, PA 19013
(610) 619-7400
1760452494 ROBERT E GUILDAY MD
Individual
SurgeryONE MEDICAL CENTER BLVD SUITE 241
CHESTER, PA 19013
(610) 619-7400
1760581268MS. JENNIFER A HARTLE P.A.
Individual
Physician AssistantONE MEDICAL CENTER BLVD CCMC, POB II, SUITE 324
UPLAND, PA 19013
(610) 876-0347
1790853497 AREZOO GHANEIE MD
Individual
Internal Medicine (Hematology & Oncology)ONE MEDICAL CENTER BLVD SUITE 341 CROZER REGIONAL CANCER CENTER
UPLAND, PA 19013
(610) 619-7420
1962415885SURGICAL CARE ASSOCIATES
Organization
SurgeryONE MEDICAL CENTER BLVD SUITE 241
UPLAND, PA 19013
(610) 619-7400
1982766507DR. ANNE M RAUNIO MD
Individual
Obstetrics & Gynecology (Gynecology)ONE MEDICAL CENTER BLVD SUITE 333
UPLAND, PA 19013
(610) 872-4900