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THERESA M DOMAGOLA ACNP-BC, PMHNP-BC
NPI 1184676322
Nurse Practitioner - Acute Care in Jacksonville, FL

Active since May 16, 2006PECOS EnrolledAccepts Medicare Assignment
81.9/100
CMS Quality Rating
15255 MAX LEGGETT PKWY STE 3600, JACKSONVILLE, FL 32218(904) 427-6895 Get Directions Write a Review

NPPES record last updated: June 24, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Theresa M Domagola Acnp-bc, Pmhnp-bc NPPES

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

THERESA M DOMAGOLA ACNP-BC, PMHNP-BC (NPI 1184676322) is an individual acute care provider in Jacksonville, Florida, licensed in Florida (11002747) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Shands Jacksonville, and is a graduate of University Of Rochester School Of Medicine And Dentistry (2003).

NPPES Registry Identity

NPI1184676322
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameTHERESA M DOMAGOLACredential: ACNP-BC, PMHNP-BC
Location Address15255 MAX LEGGETT PKWY STE 3600Jacksonville, FL 32218-7279
Mailing Address15255 Max Leggett Pkwy Ste 3600Jacksonville, FL 32218-7279 · (904) 427-6895
Phone(904) 427-6895
Sole ProprietorNo
Medical School CMSUniversity Of Rochester School Of Medicine And DentistryGraduated 2003
Enumeration DateMay 16, 2006
Last NPPES UpdateJune 24, 2024
NPPES CertifiedJune 24, 2024
✔ NPI 1184676322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
Licenses✔ Licensed in FL · 11002747✔ Licensed in NY · 430210
15255 MAX LEGGETT PKWY STE 3600, Jacksonville, FL 32218
Open in Google Maps ↗

Other Identifiers 2

Other70008ARA6884Mcr
Medicaid02601196NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Oscar Health Maintenance Organization of Florida, UnitedHealthcare.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

Theresa M Domagola Acnp-bc, Pmhnp-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 ID840234050
PECOS Enrollment IDI20191227001192
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 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.
143 services115 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
66 services66 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
33 services25 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.
19 services14 patients

Hospital Affiliations CMS Care Compare

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

Shands Jacksonville

Acute Care Hospitals · Jacksonville, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100001
Location655 W 8th StJacksonville, FL 32209 · Duval County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32218 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.9/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.43
Promoting Interoperability100
Improvement Activities40
Cost59.59

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 Theresa Domagola's NPI number?

The NPI number for Theresa Domagola is 1184676322. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Theresa Domagola located?

Theresa Domagola practices at 15255 Max Leggett Pkwy Ste 3600, Jacksonville, FL 32218. The listed phone number is (904) 427-6895.

What is Theresa Domagola's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Theresa Domagola enrolled in Medicare?

Yes. Theresa Domagola 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.

What insurance does Theresa Domagola accept?

Health plans from AvMed, Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Theresa Domagola 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 Theresa Domagola affiliated with any hospitals?

According to CMS data, Theresa Domagola is affiliated with Shands Jacksonville.

When was this NPI record last updated?

The NPPES record for Theresa Domagola was last updated on June 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.