MARIANE DOMINGO FNP-BC
NPI 1063932184
Nurse Practitioner - Family in Chicago, IL

Q: What is Mariane Domingo's NPI number?

The NPI number for Mariane Domingo is 1063932184. It was assigned to this individual provider in the NPPES registry on June 20, 2017. The provider is also known as Mariane Manalo.

Q: What is Mariane Domingo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Mariane Domingo was last updated on June 23, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 20, 2017PECOS EnrolledAccepts Medicare Assignment

3134 N CLARK ST, CHICAGO, IL 60657(773) 766-1949(773) 766-4908 Get Directions Write a Review

NPPES record last updated: June 23, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mariane Domingo Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIANE DOMINGO FNP-BC (NPI 1063932184) is an individual family provider in Chicago, Illinois, licensed in Illinois (209016077) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS, is affiliated with Advocate Illinois Masonic Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1063932184

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARIANE DOMINGOCredential: FNP-BC

Location Address3134 N CLARK STChicago, IL 60657-4414

Mailing Address29373 Network PlChicago, IL 60673-1293 · (847) 390-5900 · Fax (847) 390-4757

Phone(773) 766-1949

Fax(773) 766-4908

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJune 20, 2017

Last NPPES UpdateJune 23, 2022

NPPES CertifiedJune 23, 2022

✔ NPI 1063932184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209016077

3134 N CLARK ST, Chicago, IL 60657

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Other Names 1

Former Name (1)Mariane Manalo

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mariane Domingo Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224371547

PECOS Enrollment IDI20190529002720

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

53 services46 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

37 services37 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

18 services18 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

16 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Advocate Illinois Masonic Medical Center

Acute Care Hospitals · Chicago, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140182

Location836 West Wellington AvenueChicago, IL 60657 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60657 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SORIN C DANCIU M.D.

Internal Medicine (Cardiovascular Disease)