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ARELY DOMINGUEZ GONZALEZ FNP
NPI 1548826670
Nurse Practitioner - Family in Fountain, CO

Active since May 14, 2019PECOS Enrolled
350 LYCKMAN PL, FOUNTAIN, CO 80817(719) 632-5700(719) 322-0776 Get Directions Write a Review

NPPES record last updated: August 25, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 25, 2021, May 14, 2019 (2 updates tracked since 2019).

About Arely Dominguez Gonzalez Fnp NPPES

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

ARELY DOMINGUEZ GONZALEZ FNP (NPI 1548826670) is an individual family provider in Fountain, Colorado, licensed in Colorado (C-APN.0003054-C-NP) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548826670
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameARELY DOMINGUEZ GONZALEZCredential: FNP
Location Address350 LYCKMAN PLFountain, CO 80817-2861
Mailing AddressPo Box 669Ahoskie, NC 27910-0669 · (252) 209-0237 · Fax (252) 209-0197
Phone(719) 632-5700
Fax(719) 322-0776
Sole ProprietorNo
Enumeration DateMay 14, 2019
Last NPPES UpdateAugust 25, 20212 updates tracked since enumeration
NPPES CertifiedAugust 25, 2021
✔ NPI 1548826670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in CO · C-APN.0003054-C-NP✔ Licensed in NC · 5011630
350 LYCKMAN PL, Fountain, CO 80817
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Arely Dominguez Gonzalez Fnp 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 Reassignments

2

Medicare enrollment records show Arely Dominguez Gonzalez reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Peak Vista Community Health Centers
13 mi
Federally Qualified Health Center (FQHC)
3205 N ACADEMY BLVD, SUITE 130
Colorado Springs, CO 80917
  • Reassigned Medicare billing, Colorado enrollment
  • 355 clinicians in this Medicare group
NPI 1730166034 (719) 632-5700
Liberty Healthcare Group, LLC
1,520 mi
Case Management
2550 S 41ST ST
Wilmington, NC 28403
  • Reassigned Medicare billing, North Carolina enrollment
  • 27 clinicians in this Medicare group
NPI 1629217856 (910) 362-9311

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 80817 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
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
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 11

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

PATRICK MICHAEL CASSIDY P.A.-C
Physician Assistant
350 LYCKMAN PL
FOUNTAIN, CO 80817
El Paso County (719) 322-0777
KAYLA MARCHESANI PA-C
Physician Assistant
350 LYCKMAN PL
FOUNTAIN, CO 80817
El Paso County (719) 632-5700
KELLI L SCOTT PA
Physician Assistant (Medical)
350 LYCKMAN PL
FOUNTAIN, CO 80817
El Paso County (719) 632-5700
CHELSEA STAVER LPC
Counselor (Professional)
350 LYCKMAN PL
FOUNTAIN, CO 80817
El Paso County (719) 522-6227
MRS. MALORY KAY SPLAWN FNP-C
Nurse Practitioner (Family)
350 LYCKMAN PL
FOUNTAIN, CO 80817
El Paso County (719) 632-5700
ANDREW G. NEAL RN, MS(N), FNP-BC
Nurse Practitioner (Family)
350 LYCKMAN PL
FOUNTAIN, CO 80817
El Paso County (719) 632-5700
CHERIE MARIE MILLIRONS PA-C
Physician Assistant
350 LYCKMAN PL
FOUNTAIN, CO 80817
El Paso County (719) 632-5700
JEFFREY DAVID DERRY LPC
Counselor (Professional)
350 LYCKMAN PL
FOUNTAIN, CO 80817
El Paso County (719) 632-5700

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 Arely Dominguez Gonzalez's NPI number?

The NPI number for Arely Dominguez Gonzalez is 1548826670. It was assigned to this individual provider in the NPPES registry on May 14, 2019.

Where is Arely Dominguez Gonzalez located?

Arely Dominguez Gonzalez practices at 350 Lyckman Pl, Fountain, CO 80817. The listed phone number is (719) 632-5700.

What is Arely Dominguez Gonzalez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Arely Dominguez Gonzalez enrolled in Medicare?

Yes. Arely Dominguez Gonzalez is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Arely Dominguez Gonzalez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Arely Dominguez Gonzalez reassigns Medicare benefits to 2 organizations: Peak Vista Community Health Centers (Colorado Springs, CO) and Liberty Healthcare Group, LLC (Wilmington, NC). Each 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 Arely Dominguez Gonzalez'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 Arely Dominguez Gonzalez was last updated on August 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.