JACOB DOMORACKI CRNP NPI 1245919448

NPI Information

  • NPI: 1245919448
  • Provider Name: JACOB DOMORACKI, CRNP
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 232 W 25TH ST
    ERIE, PA
    ZIP 16544
  • Phone: (814) 452-5000

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NPI Details

Jacob Domoracki, CRNP is an acute care nurse practitioner in Erie, PA with 3 years of experience. Jacob Domoracki, CRNP NPI is 1245919448. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

232 W 25TH ST
ERIE, PA
ZIP 16544-001
Phone: (814) 452-5000

The NPI 1245919448 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/14/2023 and was last updated on 11/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WC0200XRegistered NurseCritical Care MedicineRN670780PENNSYLVANIANo
2363LA2100XNurse PractitionerAcute CareSP028313PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1RN670780OTHERPENNSYLVANIAREGISTERED NURSE LICENSE
2SP028313OTHERPENNSYLVANIACERTIFIED REGISTERED NURSE PRACTITIONER - ADULT-GERONTOLOGY ACUTE CARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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