Jenna Mae Domino, APNP in Manitowoc, WI - Medicare Nurse Practitioner

Jenna Mae Domino, APNP is a medicare enrolled "Nurse Practitioner - Family" in Manitowoc, Wisconsin. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Froedtert Manitowoc Medical Group, Llc and her current practice location is 2300 Western Ave, Manitowoc, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 320-3512.

Jenna Mae Domino is licensed to practice in Wisconsin (license number 8540-33) 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 1780174664.

Contact Information

	Jenna Mae Domino, APNP
	2300 Western Ave, Manitowoc, WI 54220
	(920) 320-3512
	Not Available

Map and Direction

Provider's Profile

Full Name	Jenna Mae Domino
Gender	Female
Speciality	Nurse Practitioner
Experience	6 Years
Location	2300 Western Ave, Manitowoc, Wisconsin
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:

Jenna Mae Domino graduated from nursing school in 2018

NPI Data:

NPI Number: 1780174664
Provider Enumeration Date: 05/16/2018
Last Update Date: 01/23/2019

Medicare PECOS Information:

PECOS PAC ID: 8628329133
Enrollment ID: I20180922000031

Medical Identifiers

Medical identifiers for Jenna Mae Domino such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780174664	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	218918-30 (Wisconsin)	Secondary
363LF0000X	Nurse Practitioner - Family	8540-33 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Holy Family Memorial	Manitowoc, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Froedtert Manitowoc Medical Group, Llc	2365836954	118

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. Jenna Mae Domino allows following entities to bill medicare on her behalf.

Entity Name	Froedtert Manitowoc Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437829975 PECOS PAC ID: 2365836954 Enrollment ID: O20220224001282

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. Jenna Mae 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
Jenna Mae Domino, APNP 937 S 39th St, Manitowoc, WI 54220-4707 Ph: () -	Jenna Mae Domino, APNP 2300 Western Ave, Manitowoc, WI 54220 Ph: (920) 320-3512

Reviews and Comments

Nurse Practitioner Nurses in Manitowoc, WI

Barbara J Backus, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1650 S 41st St, Manitowoc, WI 54220 Phone: 920-320-4500 Fax: 920-682-9378
Jessica L Lietzan, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1650 S 41st St, Manitowoc, WI 54220 Phone: 920-320-2436
Veronica Mcfarlane, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1650 S 41st St, Manitowoc, WI 54220 Phone: 920-320-2436
Nicole Artamenko, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1650 S 41st St, Manitowoc, WI 54220 Phone: 920-320-2436
Brenda Stallbaum, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 339 Reed Ave, Manitowoc, WI 54220 Phone: 920-320-8600
Angela R Vandewettering, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1111 Bayshore Dr, Manitowoc, WI 54220 Phone: 920-682-6376
Andrew Allen Malkowski, APNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 926 S 8th St, Manitowoc, WI 54220 Phone: 920-683-4230 Fax: 920-683-4902

Jenna Mae Domino, APNP - Medicare Nurse Practitioner in Manitowoc, WI