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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: August 16, 2026.

About Michelle Mae Domingo NPPES

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

MICHELLE MAE DOMINGO (NPI 1457660391) is an individual medical provider in South Gate, California, licensed in California (52600) and active in the NPI registry since September 2010. She is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2015).

NPPES Registry Identity

NPI1457660391
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMICHELLE MAE DOMINGO
Location Address4075 TWEEDY BLVDSouth Gate, CA 90280-6146
Mailing Address4075 Tweedy BlvdSouth Gate, CA 90280-6146 · (323) 566-4111
Phone(323) 566-4111
Sole ProprietorNo
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2015
Enumeration DateSeptember 27, 2010
Last NPPES UpdateJune 23, 2015
✔ NPI 1457660391 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CA · 52600
4075 TWEEDY BLVD, South Gate, CA 90280
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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 and accepts Medicare assignment

Michelle Mae Domingo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446568984
PECOS Enrollment IDI20151001002076
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.

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
14 suppliers44 claims98 services$5.03 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
13 suppliers31 claims39 services$0.79 avg. paid by Medicare
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims360 services$2.40 avg. paid by Medicare
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 B4150
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims4,176 services$0.30 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
1 supplier20 claims20 services$16.17 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NARCISO AZURIN M.D.
Family Medicine
4075 TWEEDY BLVD
SOUTH GATE, CA 90280
Los Angeles County (323) 566-4111
NARCISO M AZURIN MD INC
Family Medicine
4075 TWEEDY BLVD
SOUTH GATE, CA 90280
Los Angeles County (323) 566-4111
CHARITY HEALTH
Clinic/Center (Federally Qualified Health Center (FQHC))
4075 TWEEDY BLVD
SOUTH GATE, CA 90280
Los Angeles County (323) 566-4111
ROBERT ANTHONY AZURIN M.D.
Family Medicine
4075 TWEEDY BLVD
SOUTH GATE, CA 90280
Los Angeles County (323) 566-4111
ROBERT AZURIN, M.D. INC
Clinic/Center (Primary Care)
4075 TWEEDY BLVD
SOUTH GATE, CA 90280
Los Angeles County (323) 566-4111

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 Domingo's NPI number?

The NPI number for Michelle Domingo is 1457660391. It was assigned to this individual provider in the NPPES registry on September 27, 2010.

Where is Michelle Domingo located?

Michelle Domingo practices at 4075 Tweedy Blvd, South Gate, CA 90280. The listed phone number is (323) 566-4111.

What is Michelle Domingo's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Michelle Domingo enrolled in Medicare?

Yes. Michelle Domingo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Michelle Domingo was last updated on June 23, 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.