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SARAH E DOMINIQUE APN CDE
NPI 1114348620
Clinical Nurse Specialist - Pediatrics in Peoria, IL

Active since December 31, 2013PECOS Enrolled
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 624-2480 Get Directions Write a Review

NPPES record last updated: December 21, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Sarah E Dominique Apn Cde NPPES

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

SARAH E DOMINIQUE APN CDE (NPI 1114348620) is an individual pediatrics provider in Peoria, Illinois, licensed in Illinois (209010901) and active in the NPI registry since December 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114348620
Entity TypeIndividualFemale
Primary Taxonomy364SP0200X
Provider Legal NameSARAH E DOMINIQUECredential: APN CDE
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address1400 Flossmoor AveWashington, IL 61571-1108
Phone(309) 624-2480
Sole ProprietorNo
Enumeration DateDecember 31, 2013
Last NPPES UpdateDecember 21, 2017
✔ NPI 1114348620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse Specialist · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SP0200X
License✔ Licensed in IL · 209010901
530 NE GLEN OAK AVE, Peoria, IL 61637
Open in Google Maps ↗

Other Names 1

Former Name (1)Sarah E Allen

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sarah E Dominique Apn Cde is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Sarah Dominique reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Board Of Trustees Of The University Of Illinois
0.6 mi
Pediatrics
1 ILLINI DR
Peoria, IL 61605
  • Reassigned Medicare billing, Illinois enrollment
  • 2,127 clinicians in this Medicare group
NPI 1467425322 (309) 680-8649
Osf Multi-Specialty Group
7.4 mi
Internal Medicine
8600 N STATE ROUTE 91
Peoria, IL 61615
  • Reassigned Medicare billing, Illinois enrollment
  • 2,944 clinicians in this Medicare group
NPI 1922445527 (309) 683-5050

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

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. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109
ABIGAIL V. WELU DO
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-6710
DR. JAMES DANIEL DEWAR D.O.
Internal Medicine (Interventional Cardiology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-7257

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 Sarah Dominique's NPI number?

The NPI number for Sarah Dominique is 1114348620. It was assigned to this individual provider in the NPPES registry on December 31, 2013. The provider is also known as Sarah E Allen.

Where is Sarah Dominique located?

Sarah Dominique practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 624-2480.

What is Sarah Dominique's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Pediatrics, with taxonomy code 364SP0200X.

Is Sarah Dominique enrolled in Medicare?

Yes. Sarah Dominique is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Sarah Dominique's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sarah Dominique reassigns Medicare benefits to 2 organizations: Board Of Trustees Of The University Of Illinois (Peoria, IL) and Osf Multi-Specialty Group (Peoria, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sarah Dominique's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sarah Dominique was last updated on December 21, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.