1. Home
  2. Directory
  3. Oregon
  4. La Grande
  5. Nurse Practitioner
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MARI PATRICIA DOMINGUEZ NP-C
NPI 1265197040
Nurse Practitioner - Psychiatric/Mental Health in La Grande, OR

Active since November 05, 2021PECOS EnrolledAccepts Medicare Assignment
2301 COVE AVE, LA GRANDE, OR 97850(541) 962-8800(541) 963-5272 Get Directions Write a Review

NPPES record last updated: September 24, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 24, 2026, Nov 5, 2021 (2 updates tracked since 2021).

About Mari Patricia Dominguez Np-c NPPES

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

MARI PATRICIA DOMINGUEZ NP-C (NPI 1265197040) is an individual psychiatric/mental health provider in La Grande, Oregon, licensed in Oregon (202111998NP-PP) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in La Grande, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1265197040
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMARI PATRICIA DOMINGUEZCredential: NP-C
Location Address2301 COVE AVELa Grande, OR 97850-3906
Mailing Address2301 Cove AveLa Grande, OR 97850-3906 · (541) 962-8800 · Fax (541) 963-5272
Phone(541) 962-8800
Fax(541) 963-5272
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateNovember 5, 2021
Last NPPES UpdateSeptember 24, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2026
✔ NPI 1265197040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in OR · 202111998NP-PP
2301 COVE AVE, La Grande, OR 97850
Open in Google Maps ↗

Secondary Practice Location 1

Location 1105 Fir St Ste 327LA Grande, OR 97850-2663 · Phone (541) 246-3638 · Fax (541) 234-3777

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mari Patricia Dominguez Np-c 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 ID5991713307
PECOS Enrollment IDI20211213002520
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 Mari Dominguez reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Center For Human Development, Inc.
Same address
Community/Behavioral Health
2301 COVE AVENUE
Lagrande, OR 97850
  • Reassigned Medicare billing, Oregon enrollment
  • 9 clinicians in this Medicare group
NPI 1114051315 (541) 962-8800
New Directions Northwest, Inc
39 mi
Community/Behavioral Health
3425 13TH ST
Baker City, OR 97814
  • Reassigned Medicare billing, Oregon enrollment
  • 15 clinicians in this Medicare group
NPI 1235124462 (541) 523-7400

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 97850 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
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$97.16 typical visit price
range $17.68 – $136.19
Typical copayment $24.29 (range $4.42 – $34.04)
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.

JENNIFER R HERNANDEZ CRM
Counselor
2301 COVE AVE
LA GRANDE, OR 97850
Union County (541) 962-8800
SEAN MICHAEL CREWS
Peer Specialist
2301 COVE AVE
LA GRANDE, OR 97850
Union County (541) 962-8800
ZOLA MORRIS
Counselor (Mental Health)
2301 COVE AVE
LA GRANDE, OR 97850
Union County (541) 962-8800
ALISHA DELATORI
Counselor (Mental Health)
2301 COVE AVE
LA GRANDE, OR 97850
Union County (541) 962-8800
TYLEE COOPER CLARK CSWA
Social Worker (Clinical)
2301 COVE AVE
LA GRANDE, OR 97850
Union County (541) 962-8800
DESTINY K PAYNE
Counselor (Addiction (Substance Use Disorder))
2301 COVE AVE
LA GRANDE, OR 97850
Union County (541) 962-8800
CRYSTAL GALLOWAY RN
Registered Nurse (Community Health)
2301 COVE AVE
LA GRANDE, OR 97850
Union County (541) 962-8800
KYLEE L KOSHINSKY RN
Registered Nurse (Community Health)
2301 COVE AVE
LA GRANDE, OR 97850
Union County (541) 962-8800

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 Mari Dominguez's NPI number?

The NPI number for Mari Dominguez is 1265197040. It was assigned to this individual provider in the NPPES registry on November 5, 2021.

Where is Mari Dominguez located?

Mari Dominguez practices at 2301 Cove Ave, La Grande, OR 97850. The listed phone number is (541) 962-8800.

What is Mari Dominguez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Mari Dominguez enrolled in Medicare?

Yes. Mari 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.

Which organizations bill Medicare for Mari Dominguez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mari Dominguez reassigns Medicare benefits to 2 organizations: Center For Human Development, Inc. (Lagrande, OR) and New Directions Northwest, Inc (Baker City, OR). 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 Mari Dominguez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mari Dominguez accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan list Mari 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.

When was this NPI record last updated?

The NPPES record for Mari Dominguez was last updated on September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 34 days 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.