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MICHELLE DOMINGUEZ M.D.
NPI 1396159695
Pediatrics in Providence, RI

Active since June 13, 2014PECOS Enrolled
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-3996 Get Directions Write a Review

NPPES record last updated: June 30, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 30, 2020, Jun 30, 2017 (2 updates tracked since 2017).

About Michelle Dominguez M.d. NPPES

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

MICHELLE DOMINGUEZ M.D. (NPI 1396159695) is an individual pediatrics provider in Providence, Rhode Island, licensed in Rhode Island (CLP03881) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396159695
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMICHELLE DOMINGUEZCredential: M.D.
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address991 Wimbledon DrMelbourne, FL 32940-1517
Phone(401) 444-3996
Sole ProprietorNo
Enumeration DateJune 13, 2014
Last NPPES UpdateJune 30, 20202 updates tracked since enumeration
NPPES CertifiedJune 30, 2020
✔ NPI 1396159695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in RI · CLP03881
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
593 EDDY ST, Providence, RI 02903
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michelle Dominguez M.d. 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 Reassignment

Medicare enrollment records show Michelle Dominguez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Stc Pediatrics LLC
212 mi
Pediatrics
680 HEACOCK RD STE 200
Yardley, PA 19067
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 479 clinicians in this Medicare group
NPI 1811532518 (215) 493-6519

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 02903 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
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
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. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695
FANNY HUANG MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4741

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 Michelle Dominguez's NPI number?

The NPI number for Michelle Dominguez is 1396159695. It was assigned to this individual provider in the NPPES registry on June 13, 2014.

Where is Michelle Dominguez located?

Michelle Dominguez practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-3996.

What is Michelle Dominguez's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Michelle Dominguez enrolled in Medicare?

Yes. Michelle Dominguez is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Michelle Dominguez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michelle Dominguez reassigns Medicare benefits to Stc Pediatrics LLC (Yardley, PA). The 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 Michelle Dominguez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michelle Dominguez accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Michelle 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 Michelle Dominguez was last updated on June 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.