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MIRNOUVE DOMOND DO
NPI 1609296052
Internal Medicine in Decatur, GA

Active since April 24, 2014PECOS EnrolledAccepts Medicare Assignment
2545 LAWRENCEVILLE HWY STE 200, DECATUR, GA 30033(770) 934-7876(770) 491-8434 Get Directions Write a Review

NPPES record last updated: May 22, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 11, 2023, Sep 30, 2019 (2 updates tracked since 2019).

About Mirnouve Domond Do NPPES

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

MIRNOUVE DOMOND DO (NPI 1609296052) is an individual internal medicine provider in Decatur, Georgia, licensed in Georgia (84233) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS, is affiliated with Emory Decatur Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1609296052
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMIRNOUVE DOMONDCredential: DO
Location Address2545 LAWRENCEVILLE HWY STE 200Decatur, GA 30033-3240
Mailing Address2545 Lawrenceville Hwy Ste 200Decatur, GA 30033-3240 · (770) 934-7876 · Fax (770) 491-8434
Phone(770) 934-7876
Fax(770) 491-8434
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateApril 24, 2014
Last NPPES UpdateMay 22, 20242 updates tracked since enumeration
NPPES CertifiedMay 22, 2024
✔ NPI 1609296052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 84233
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2545 LAWRENCEVILLE HWY STE 200, Decatur, GA 30033
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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 and accepts Medicare assignment

Mirnouve Domond Do 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 ID1456780451
PECOS Enrollment IDI20200326000397
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 Mirnouve Domond reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northside Primary Care Professional Services,llc
8.0 mi
Family Medicine
1000 JOHNSON FERRY RD NE
Atlanta, GA 30342
  • Reassigned Medicare billing, Georgia enrollment
  • 466 clinicians in this Medicare group
NPI 1922397553 (855) 709-4535
Lawrenceville Family Practice
18 mi
Health Maintenance Organization
1730 LAWRENCEVILLE SUWANEE RD
Lawrenceville, GA 30043
  • Reassigned Medicare billing, Georgia enrollment
  • 3 clinicians in this Medicare group
NPI 1831378249 (770) 338-0089

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
38 services32 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
18 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Emory Decatur Hospital

Acute Care Hospitals · Decatur, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110076
Location2701 N Decatur RoadDecatur, GA 30033 · De Kalb County
Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30033 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

Referred Medical Equipment & Supplies CMS DME claims

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
10 suppliers15 claims41 services$6.62 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

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

NORTHSIDE NAMA PROFESSIONAL SERVICES, LLC
Family Medicine
2545 LAWRENCEVILLE HWY STE 200
DECATUR, GA 30033
Dekalb County (770) 934-7876

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 Mirnouve Domond's NPI number?

The NPI number for Mirnouve Domond is 1609296052. It was assigned to this individual provider in the NPPES registry on April 24, 2014.

Where is Mirnouve Domond located?

Mirnouve Domond practices at 2545 Lawrenceville Hwy Ste 200, Decatur, GA 30033. The listed phone number is (770) 934-7876.

What is Mirnouve Domond's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mirnouve Domond enrolled in Medicare?

Yes. Mirnouve Domond 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.

Which organizations bill Medicare for Mirnouve Domond's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mirnouve Domond reassigns Medicare benefits to 2 organizations: Northside Primary Care Professional Services,llc (Atlanta, GA) and Lawrenceville Family Practice (Lawrenceville, GA). 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 Mirnouve Domond's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mirnouve Domond accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Mirnouve Domond as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mirnouve Domond affiliated with any hospitals?

According to CMS data, Mirnouve Domond is affiliated with Emory Decatur Hospital and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Mirnouve Domond was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.