Dominique Samarane Bultsma, MD in Johns Island, SC

Dominique Samarane Bultsma, MD is a medicare enrolled "Internal Medicine" physician in Johns Island, South Carolina. She went to Wayne State University School Of Medicine and graduated in 2020 and has 6 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice 24 On Physicians Of Sc Llc and her current practice location is 345 Freshfields Dr Ste J101, Johns Island, South Carolina. You can reach out to her office (for appointments etc.) via phone at (843) 768-4800.

Dominique Samarane Bultsma is licensed to practice in South Carolina (license number 90584) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1033733704.

Contact Information

	Dominique Samarane Bultsma, MD
	345 Freshfields Dr Ste J101, Johns Island, SC 29455-5443
	(843) 768-4800
	(843) 606-8039

Map and Direction

Physician's Profile

Full Name	Dominique Samarane Bultsma
Gender	Female
Speciality	Internal Medicine
Experience	6 Years
Location	345 Freshfields Dr Ste J101, Johns Island, South Carolina
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dominique Samarane Bultsma attended and graduated from Wayne State University School Of Medicine in 2020

NPI Data:

NPI Number: 1033733704
Provider Enumeration Date: 05/29/2020
Last Update Date: 02/23/2026

Medicare PECOS Information:

PECOS PAC ID: 8729407895
Enrollment ID: I20231107000516

Medical Identifiers

Medical identifiers for Dominique Samarane Bultsma such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033733704	NPI	-	NPPES
905846	Medicaid	SC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	90584 (South Carolina)	Primary
207R00000X	Internal Medicine	LL84222 (South Carolina)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Roper Hospital	Charleston, SC	Hospital
Bon Secours-st Francis Xavier Hospital	Charleston, SC	Hospital
Roper St Francis Hospital-berkely Inc	Moncks corner, SC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
24 On Physicians Of Sc Llc	5890127344	98

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dominique Samarane Bultsma allows following entities to bill medicare on her behalf.

Entity Name	24 On Physicians Of Sc Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144877655 PECOS PAC ID: 5890127344 Enrollment ID: O20191121001203

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dominique Samarane Bultsma is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dominique Samarane Bultsma, MD Po Box 751649, Charlotte, NC 28275-1649 Ph: (888) 472-0043	Dominique Samarane Bultsma, MD 345 Freshfields Dr Ste J101, Johns Island, SC 29455-5443 Ph: (843) 768-4800

Reviews and Comments

Internal Medicine Doctors in Johns Island, SC

C Gregory Martin, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 3226 Maybank Hwy, Johns Island, SC 29455 Phone: 843-266-9800
Brittney Rodriguez, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 1857 Seabrook Island Rd, Johns Island, SC 29455 Phone: 305-785-0923
Brooke Alexa Brooks, PA-C Internal Medicine Medicare: Medicare Enrolled Practice Location: 3227 Walter Dr Ste 1b, Johns Island, SC 29455 Phone: 843-872-5454
Dr. Bernard Mansheim, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 3226 Maybank Highway Ste 1a, Johns Island, SC 29455 Phone: 843-266-9800 Fax: 843-266-9801
James Crawford Allen, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 3237 Middle Dam Ct, Johns Island, SC 29455 Phone: 843-768-4105 Fax: 843-768-4105
David Seignious, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3312 Maybank Hwy, Suite A, Johns Island, SC 29455 Phone: 843-557-1111 Fax: 843-557-1050

Dominique Samarane Bultsma, MD - Medicare Internal Medicine in Johns Island, SC