Edna Domino, APRN is a medicare enrolled "Nurse Practitioner" physician in Fort Myers, Florida. Her current practice location is
3033 Winkler Ave Unit 100, Fort Myers, Florida. You can reach out to her office (for appointments etc.) via phone at
(239) 277-7070.
Edna Domino is licensed to practice in Florida (license number APRN1649932) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1225026941.
Physician's Profile
| Full Name | Edna Domino |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 3033 Winkler Ave Unit 100, Fort Myers, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1225026941
- Provider Enumeration Date: 10/06/2005
- Last Update Date: 12/03/2018
Medicare PECOS Information:
- PECOS PAC ID: 8022076298
- Enrollment ID: I20041221000218
Medical Identifiers
Medical identifiers for Edna Domino such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1225026941 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207X00000X | Orthopaedic Surgery | ARNP1649932 (Florida) | Secondary |
| 363L00000X | Nurse Practitioner | APRN1649932 (Florida) | Primary |
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. Edna Domino allows following entities to bill medicare on her behalf.
| Entity Name | Gesiotto,henricks,kordonowy,and Simmons,mds,pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1700803590
PECOS PAC ID: 8123163912
Enrollment ID: O20100304000424 |
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| Entity Name | Gardner Orthopedics Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1841682705
PECOS PAC ID: 2668793332
Enrollment ID: O20150605002146 |
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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. Edna Domino 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 |
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Edna Domino, APRN
3033 Winkler Ave Unit 100,
Fort Myers, FL 33916-9523
Ph: (239) 277-7070 | Edna Domino, APRN
3033 Winkler Ave Unit 100,
Fort Myers, FL 33916-9523
Ph: (239) 277-7070 |
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