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DOMINIQUE ELY AGACNP-BC
NPI 1629490081
Nurse Practitioner - Acute Care in Decatur, IL

Active since January 20, 2014PECOS EnrolledAccepts Medicare Assignment
302 W HAY ST STE 140, DECATUR, IL 62526(217) 872-2713(217) 545-1958 Get Directions Write a Review

NPPES record last updated: September 24, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 24, 2024, Jun 8, 2023 (2 updates tracked since 2023).

About Dominique Ely Agacnp-bc NPPES

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

DOMINIQUE ELY AGACNP-BC (NPI 1629490081) is an individual acute care provider in Decatur, Illinois, licensed in Illinois (209011112) and active in the NPI registry since January 2014. She is enrolled in Medicare PECOS, is affiliated with Decatur Memorial Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2013).

NPPES Registry Identity

NPI1629490081
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameDOMINIQUE ELYCredential: AGACNP-BC
Location Address302 W HAY ST STE 140Decatur, IL 62526-4168
Mailing AddressPo Box 19639Springfield, IL 62794-9639 · (217) 545-8000
Phone(217) 872-2713
Fax(217) 545-1958
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2013
Enumeration DateJanuary 20, 2014
Last NPPES UpdateSeptember 24, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2024
✔ NPI 1629490081 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in IL · 209011112
Also ListedNurse PractitionerTaxonomy 363L00000X · License 209011112 (IL)
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 209011112 (IL)
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 209011112 (IL)
302 W HAY ST STE 140, Decatur, IL 62526
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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

Dominique Ely Agacnp-bc 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 ID6002046935
PECOS Enrollment IDI20140220000660
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.

Hospital Affiliations CMS Care Compare

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

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140135
Location2300 North Edward StreetDecatur, IL 62526 · Macon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62526 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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

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

JAMIE J LUECKE NP
Nurse Practitioner
302 W HAY ST STE 140
DECATUR, IL 62526
Macon County (217) 872-2713

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 Dominique Ely's NPI number?

The NPI number for Dominique Ely is 1629490081. It was assigned to this individual provider in the NPPES registry on January 20, 2014.

Where is Dominique Ely located?

Dominique Ely practices at 302 W Hay St Ste 140, Decatur, IL 62526. The listed phone number is (217) 872-2713.

What is Dominique Ely's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Dominique Ely enrolled in Medicare?

Yes. Dominique Ely 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.

Is Dominique Ely affiliated with any hospitals?

According to CMS data, Dominique Ely is affiliated with Decatur Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Dominique Ely was last updated on September 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.