1. Home
  2. Directory
  3. New York
  4. Smithtown
  5. Social Worker
  6. NPI Profile

MRS. JESSICA CATHERINE DOMINGUEZ LCSW
NPI 1407176209
Social Worker - Clinical in Smithtown, NY

Active since June 03, 2010PECOS Enrolled
11 ROUTE 111, SMITHTOWN, NY 11787(631) 920-8300(631) 920-8460 Get Directions Write a Review

NPPES record last updated: August 20, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mrs. Jessica Catherine Dominguez Lcsw NPPES

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

MRS. JESSICA CATHERINE DOMINGUEZ LCSW (NPI 1407176209) is an individual clinical provider in Smithtown, New York, licensed in New York (082105) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1407176209
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. JESSICA CATHERINE DOMINGUEZCredential: LCSW
Location Address11 ROUTE 111Smithtown, NY 11787-3712
Mailing Address11 Route 111Smithtown, NY 11787-3712 · (631) 920-8300 · Fax (631) 920-8460
Phone(631) 920-8300
Fax(631) 920-8460
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJune 3, 2010
Last NPPES UpdateAugust 20, 2015
✔ NPI 1407176209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · 082105
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.
Also ListedSocial WorkerTaxonomy 104100000X · License 080537-1 (NY)
11 ROUTE 111, Smithtown, NY 11787
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Jessica Catherine Dominguez Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3072733120
PECOS Enrollment IDI20141013001672
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 Jessica Dominguez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Welllife Network Inc.
9.8 mi
Case Management
3600 ROUTE 112
Coram, NY 11727
  • Reassigned Medicare billing, New York enrollment
  • 49 clinicians in this Medicare group
NPI 1386817906 (631) 920-8302

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 11787 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 $67.40 – $203.53
Typical copayment $0.00 (range $16.85 – $50.88)
Most-billed visit code NA
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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.

MR. KEVFOY LENROY FLETCHER MASTERS IN SOCIAL WK
Counselor
11 ROUTE 111
SMITHTOWN, NY 11787
Suffolk County (631) 920-8303
STEPHANIE GRANATA
Student in an Organized Health Care Education/Training Program
11 ROUTE 111
SMITHTOWN, NY 11787
Suffolk County (631) 920-8300
LAURA CARRANO
Student in an Organized Health Care Education/Training Program
11 ROUTE 111
SMITHTOWN, NY 11787
Suffolk County (631) 920-8306
GAYLE MCCARTHY LCSW
Social Worker (Clinical)
11 ROUTE 111
SMITHTOWN, NY 11787
Suffolk County (631) 920-8300
VAISHNAVI VADDIGIRI M.D.
Psychiatry & Neurology (Psychiatry)
11 ROUTE 111
SMITHTOWN, NY 11787
Suffolk County (631) 920-8300
ALICIA MERCADO
Case Manager/Care Coordinator
11 ROUTE 111
SMITHTOWN, NY 11787
Suffolk County (631) 920-8346
AMANDA M COSTA
Case Manager/Care Coordinator
11 ROUTE 111
SMITHTOWN, NY 11787
Suffolk County (631) 920-8303
PAMELA PAGONES
Student in an Organized Health Care Education/Training Program
11 ROUTE 111
SMITHTOWN, NY 11787
Suffolk County (631) 920-8306

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 Jessica Dominguez's NPI number?

The NPI number for Jessica Dominguez is 1407176209. It was assigned to this individual provider in the NPPES registry on June 3, 2010.

Where is Jessica Dominguez located?

Jessica Dominguez practices at 11 Route 111, Smithtown, NY 11787. The listed phone number is (631) 920-8300.

What is Jessica Dominguez's specialty?

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

Is Jessica Dominguez enrolled in Medicare?

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

Which organization bills Medicare for Jessica Dominguez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Dominguez reassigns Medicare benefits to Welllife Network Inc. (Coram, NY). 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 Jessica Dominguez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jessica Dominguez was last updated on August 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.