| Bruce L Domm, MD | |
|
5 9th Ave N, Casselton, ND 58012-3339 | |
| (701) 347-4445 | |
| (701) 347-5276 |
| Full Name | Bruce L Domm |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 40 Years |
| Location | 5 9th Ave N, Casselton, North Dakota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730106329 | NPI | - | NPPES |
| 37983 | Other | ND | SIOUX VALLEY # |
| 0106110 | Other | ND | MEDICA # |
| 0108127 | Other | ND | MEDICA # |
| 112583400 | Medicaid | ND | |
| 142308 | Other | ND | UCARE # |
| ND100038 | Other | MN | LHS # |
| 0106108 | Other | ND | MEDICA # |
| 15375 | Medicaid | ND | |
| 93416DO | Other | ND | MNBS 3 |
| HP19507 | Other | ND | HEALTHPARTNERS # |
| 336 | Other | ND | NDBS # |
| DA9011015505 | Other | ND | PREFERRED ONE # |
| 00A28DO | Other | ND | MNBS # |
| 676560 | Other | ND | AMERICA'S PPO/ARAZ # |
| 93416DO | Other | ND | MNBS # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5341 (North Dakota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ethos Home Care | Fargo, ND | Home health agency |
| Hospice Of Red River Valley | Fargo, ND | Hospice |
| Chi Health At Home | Valley city, ND | Hospice |
| Essentia Health | Fargo, ND | Hospital |
| Sanford Medical Center Fargo | Fargo, ND | Hospital |
| Rosewood On Broadway | Fargo, ND | Nursing home |
| Villa Maria | Fargo, ND | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Innovis Health Llc | 9931298155 | 509 |
| Entity Name | Innovis Health Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215125463 PECOS PAC ID: 9931298155 Enrollment ID: O20071211000158 |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce L Domm, MD Po Box 6001, Fargo, ND 58108-6001 Ph: (701) 364-3300 | Bruce L Domm, MD 5 9th Ave N, Casselton, ND 58012-3339 Ph: (701) 347-4445 |