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MRS. NICOLE LYN DOMINICK CRNP
NPI 1306351028
Nurse Practitioner in Wilkes Barre, PA

Active since December 04, 2017PECOS Enrolled
1130 HIGHWAY 315 BLVD STE 4, WILKES BARRE, PA 18702(570) 823-8896(570) 270-2692 Get Directions Write a Review

NPPES record last updated: December 20, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 20, 2017, Dec 4, 2017 (2 updates tracked since 2017).

About Mrs. Nicole Lyn Dominick Crnp NPPES

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

MRS. NICOLE LYN DOMINICK CRNP (NPI 1306351028) is an individual nurse practitioner in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (SP018244) and active in the NPI registry since December 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306351028
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. NICOLE LYN DOMINICKCredential: CRNP
Location Address1130 HIGHWAY 315 BLVD STE 4Wilkes Barre, PA 18702-6952
Mailing Address1130 Highway 315 Blvd Ste 4Wilkes Barre, PA 18702-6952 · (570) 823-8896 · Fax (570) 270-2692
Phone(570) 823-8896
Fax(570) 270-2692
Sole ProprietorNo
Enumeration DateDecember 4, 2017
Last NPPES UpdateDecember 20, 20172 updates tracked since enumeration
✔ NPI 1306351028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in PA · SP018244
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1130 HIGHWAY 315 BLVD STE 4, Wilkes Barre, PA 18702
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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 (PECOS)

Mrs. Nicole Lyn Dominick Crnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18702 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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 5

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

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers37 claims4,350 services$0.33 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier13 claims780 services$0.20 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier12 claims2,160 services$0.99 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
3 suppliers35 claims35 services$18.98 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
3 suppliers27 claims27 services$12.63 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Nicole Dominick's NPI number?

The NPI number for Nicole Dominick is 1306351028. It was assigned to this individual provider in the NPPES registry on December 4, 2017.

Where is Nicole Dominick located?

Nicole Dominick practices at 1130 Highway 315 Blvd Ste 4, Wilkes Barre, PA 18702. The listed phone number is (570) 823-8896.

What is Nicole Dominick's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Nicole Dominick enrolled in Medicare?

Yes. Nicole Dominick is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicole Dominick was last updated on December 20, 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.