MICHELLE MAE DOMINGO
NPI 1457660391
Physician Assistant - Medical in South Gate, CA

Active since September 27, 2010PECOS EnrolledAccepts Medicare Assignment
4075 TWEEDY BLVD, SOUTH GATE, CA 90280(323) 566-4111 Get Directions Write a Review

NPPES record last updated: June 23, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Individual
  • Female
  • Years of Experience 12
  • Physician Assistant
  • Medical
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MICHELLE DOMINGO

This page provides the complete NPI Profile along with additional information for Michelle Domingo, a primary care provider established in South Gate, California with a medical specialization in Physician Assistant, focusing in medical and more than 12 years of experience. She graduated from University Of Southern California Keck School Of Medicine in 2015. The healthcare provider is registered in the NPI registry with number 1457660391 assigned on September 2010. The practitioner's primary taxonomy code is 363AM0700X with license number 52600 (CA). The provider is registered as an individual and her NPI record was last updated 11 years ago.

NPI
1457660391 Verify this NPI
Provider Name
MICHELLE MAE DOMINGO
Gender
Female
Entity Type
Individual
Location Address
4075 TWEEDY BLVD SOUTH GATE, CA 90280
Location Phone
(323) 566-4111
Mailing Address
4075 TWEEDY BLVD SOUTH GATE, CA 90280
Mailing Phone
(323) 566-4111
Medical School Name
UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduation Year
2015
Is Sole Proprietor?
No
Enumeration Date
09-27-2010
Last Update Date
06-23-2015
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A primary care provider (PCP) like Michelle Domingo sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
52600
License State
CA

Medicare Participation & PECOS Enrollment Status

Michelle Domingo is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Michelle Domingo is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 446568984

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20151001002076

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    14 DME suppliers used 44 Medicare Claims 98 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    13 DME suppliers used 31 Medicare Claims 39 Services Paid

  • DME-Wheelchairs (DD000N)

    Lightweight wheelchair (HCPCS:K0003)

    1 DME suppliers used 20 Medicare Claims 20 Services Paid

Unknown

  • Other-Enteral and Parenteral (OB006N)

    Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4034)

    1 DME suppliers used 12 Medicare Claims 360 Services Paid

  • Other-Enteral and Parenteral (OB006N)

    Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4150)

    1 DME suppliers used 12 Medicare Claims 4176 Services Paid

Reviews for MICHELLE MAE DOMINGO

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Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Family Medicine
4075 TWEEDY BLVD
SOUTH GATE, CA 90280
Family Medicine
4075 TWEEDY BLVD
SOUTH GATE, CA 90280
Clinic/Center (Primary Care)
4075 TWEEDY BLVD
SOUTH GATE, CA 90280
Family Medicine
4075 TWEEDY BLVD
SOUTH GATE, CA 90280
Clinic/Center (Federally Qualified Health Center (FQHC))
4075 TWEEDY BLVD
SOUTH GATE, CA 90280

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1457660391, enumerated as an "individual" on September 27, 2010.

The provider is located at 4075 TWEEDY BLVD SOUTH GATE, CA 90280 and the phone number is (323) 566-4111.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.