DOMINIQUE BULLOCK
NPI 1396698726
Social Worker - Clinical in Miami, FL

Q: What is Dominique Bullock's NPI number?

The NPI number for Dominique Bullock is 1396698726. It was assigned to this individual provider in the NPPES registry on February 16, 2026.

Q: What is Dominique Bullock's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Dominique Bullock was last updated on May 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.

Active since February 16, 2026PECOS Enrolled

22790 SW 112TH AVE, MIAMI, FL 33170(305) 609-1470 Get Directions Write a Review

NPPES record last updated: May 27, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dominique Bullock NPPES

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

DOMINIQUE BULLOCK (NPI 1396698726) is an individual clinical provider in Miami, Florida, licensed in Florida (SW25515) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS, maintains a secondary practice location in Homestead, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1396698726

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameDOMINIQUE BULLOCK

Location Address22790 SW 112TH AVEMiami, FL 33170-7602

Mailing Address23419 Sw 127th PlHomestead, FL 33032-9215 · (305) 609-1470

Phone(305) 609-1470

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateFebruary 16, 2026

Last NPPES UpdateMay 27, 2026

NPPES CertifiedMay 27, 2026

✔ NPI 1396698726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in FL · SW25515

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

22790 SW 112TH AVE, Miami, FL 33170

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Secondary Practice Location 1

Location 123419 SW 127th PlHomestead, FL 33032-9215 · Phone (305) 609-1470

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dominique Bullock is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911477260

PECOS Enrollment IDI20260528000065

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 Dominique Bullock reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Agape Network, Inc.

Same address

Substance Abuse Rehabilitation Facility

22790 S.W. 112 AVENUE
Miami, FL 33170

Reassigned Medicare billing, Florida enrollment
26 clinicians in this Medicare group

NPI 1326191156 (305) 235-2616

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 33170 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

$0.00 typical visit price

range $60.92 – $187.05

Typical copayment $0.00 (range $15.23 – $46.76)

Most-billed visit code NA

Established Patient

$75.86 typical visit price

range $18.99 – $150.24

Typical copayment $18.96 (range $4.74 – $37.56)

Most-billed visit code 99213

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.

TENAY RODRIGUEZ-SANCHEZ

Case Manager/Care Coordinator