DR. E.L. DOMINGO-JOHNSON MD
NPI 1215516752
General Practice in Chesterfield, MO

Q: What is E.l. Domingo-johnson's NPI number?

The NPI number for E.l. Domingo-johnson is 1215516752. It was assigned to this individual provider in the NPPES registry on April 2, 2021.

Q: What is E.l. Domingo-johnson's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since April 02, 2021PECOS EnrolledAccepts Medicare Assignment

100 CHESTERFIELD BUSINESS PKWY FL 2, CHESTERFIELD, MO 63005(954) 399-4673 Get Directions Write a Review

NPPES record last updated: December 26, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 26, 2024, Apr 2, 2021 (2 updates tracked since 2021).

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About Dr. E.l. Domingo-johnson Md NPPES

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

DR. E.L. DOMINGO-JOHNSON MD (NPI 1215516752) is an individual general practice provider in Chesterfield, Missouri, licensed in Missouri (2024043640) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and is a graduate of Texas Tech University Health Science Center School Of Medicine (2021).

NPPES Registry Identity

NPI1215516752

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. E.L. DOMINGO-JOHNSONCredential: MD

Location Address100 CHESTERFIELD BUSINESS PKWY FL 2Chesterfield, MO 63005-1271

Mailing Address3601 Sw 160th Ave Ste 250Miramar, FL 33027-6314 · (954) 399-4673

Phone(954) 399-4673

Sole ProprietorNo

Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2021

Enumeration DateApril 2, 2021

Last NPPES UpdateDecember 26, 20242 updates tracked since enumeration

NPPES CertifiedDecember 26, 2024

✔ NPI 1215516752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in MO · 2024043640

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

100 CHESTERFIELD BUSINESS PKWY FL 2, Chesterfield, MO 63005

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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

Dr. E.l. Domingo-johnson Md 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 ID1254732837

PECOS Enrollment IDI20241210002752

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.

Other Providers at the Same Location NPPES 13

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

MAIN STREET HEALTH PARTNERS, P.C.

Family Medicine