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CARLOS LORENZO DOMINGUEZ M.D
NPI 1104864768
Internal Medicine in Deltona, FL

Active since June 03, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 10D0942543 · Waiver
1857 PROVIDENCE BLVD, DELTONA, FL 32725(386) 789-8544(321) 249-9432 Get Directions Write a Review

NPPES record last updated: January 25, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Carlos Lorenzo Dominguez M.d NPPES

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

CARLOS LORENZO DOMINGUEZ M.D (NPI 1104864768) is an individual internal medicine provider in Deltona, Florida, licensed in Florida (ME0072352) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through March 12, 2028, and is affiliated with Adventhealth Fish Memorial.

NPPES Registry Identity

NPI1104864768
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameCARLOS LORENZO DOMINGUEZCredential: M.D
Location Address1857 PROVIDENCE BLVDDeltona, FL 32725-3811
Mailing Address4876 Red Brick RunSanford, FL 32771-7108 · (386) 789-8544 · Fax (321) 249-9432
Phone(386) 789-8544
Fax(321) 249-9432
Sole ProprietorYes
Medical School CMSOtherGraduated 1986
Enumeration DateJune 3, 2006
Last NPPES UpdateJanuary 25, 2012
✔ NPI 1104864768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME0072352
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1857 PROVIDENCE BLVD, Deltona, FL 32725
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Other Identifiers 3

Medicare UPING35467FL
Medicaid252750200FL
Medicare ID-Type Unspecified32987AFL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

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

Carlos Lorenzo Dominguez M.d 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 ID5698861789
PECOS Enrollment IDI20071031000035
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0942543

Carlos Dominquez MD PA · Deltona, FL
Active · expires Mar 12, 2028
CLIA Number10D0942543
Laboratory TypePhysician Office
Certificate Effective DateMarch 13, 2026
Certificate Expiration DateMarch 12, 2028
Laboratory DirectorCarlos Dominquez
Laboratory Phone(386) 789-3035
Laboratory LocationCarlos Dominquez MD PA1857 Providence Boulevard, Deltona, FL 32725
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 6

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 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.
262 services132 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
102 services102 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
102 services102 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
65 services65 patients
Transitional care management services for problem of at least moderate complexity 99495
Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
48 services33 patients
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.
21 services16 patients

Hospital Affiliations CMS Care Compare

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

Adventhealth Fish Memorial

Acute Care Hospitals · Orange City, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100072
Location1055 Saxon BlvdOrange City, FL 32763 · Volusia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32725 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers26 claims78 services$5.71 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
3 suppliers11 claims11 services$2.65 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers16 claims31 services$1.04 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

CHOICE MEDS USA, INC.
Pharmacy
1857 PROVIDENCE BLVD
DELTONA, FL 32725
Volusia County (386) 222-1173
MRS. LOURDES V. BALLET DDS
Dentist (General Practice)
1857 PROVIDENCE BLVD
DELTONA, FL 32725
Volusia County (321) 283-2850
CARLOS L DOMINGUEZ MD PA
Internal Medicine
1857 PROVIDENCE BLVD
DELTONA, FL 32725
Volusia County (386) 789-8544
BALLET DENTAL CARE
Dentist (General Practice)
1857 PROVIDENCE BLVD
DELTONA, FL 32725
Volusia County (321) 283-2850

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carlos Dominguez's NPI number?

The NPI number for Carlos Dominguez is 1104864768. It was assigned to this individual provider in the NPPES registry on June 3, 2006.

Where is Carlos Dominguez located?

Carlos Dominguez practices at 1857 Providence Blvd, Deltona, FL 32725. The listed phone number is (386) 789-8544.

What is Carlos Dominguez's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Carlos Dominguez enrolled in Medicare?

Yes. Carlos Dominguez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Carlos Dominguez hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0942543) is associated with this NPI, valid through March 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Carlos Dominguez accept?

Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Florida Health Care Plans and 3 other insurers list Carlos Dominguez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carlos Dominguez affiliated with any hospitals?

According to CMS data, Carlos Dominguez is affiliated with Adventhealth Fish Memorial.

When was this NPI record last updated?

The NPPES record for Carlos Dominguez was last updated on January 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.