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MICHELLE DOMINGUEZ
NPI 1679458137
Physician Assistant - Surgical in Orlando, FL

Active since August 06, 2025PECOS EnrolledAccepts Medicare Assignment
1720 S ORANGE AVE STE 500, ORLANDO, FL 32806(407) 540-1616(407) 540-1094 Get Directions Write a Review

NPPES record last updated: January 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 28, 2026, Aug 6, 2025 (2 updates tracked since 2025).

About Michelle Dominguez NPPES

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

MICHELLE DOMINGUEZ (NPI 1679458137) is an individual surgical provider in Orlando, Florida, licensed in Florida (PA9120952) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS, maintains a secondary practice location in Orlando, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1679458137
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMICHELLE DOMINGUEZ
Location Address1720 S ORANGE AVE STE 500Orlando, FL 32806-2967
Mailing Address1720 S Orange Ave Ste 500Orlando, FL 32806-2967 · (407) 540-1616 · Fax (407) 540-1094
Phone(407) 540-1616
Fax(407) 540-1094
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 6, 2025
Last NPPES UpdateJanuary 28, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 28, 2026
✔ NPI 1679458137 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in FL · PA9120952
1720 S ORANGE AVE STE 500, Orlando, FL 32806
Open in Google Maps ↗

Secondary Practice Location 1

Location 14850 Millenia BlvdOrlando, FL 32839-6012 · Phone (407) 264-5601

Other Identifiers 1

Medicaid129550700FL

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 Dominguez 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 ID1153816277
PECOS Enrollment IDI20251216004091
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.

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.

BRENNA SULLIVAN FULLERTON M.D.
Surgery (Pediatric Surgery)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (140) 754-0100
DEVINN SHAVONNE GOREY
Physician Assistant (Surgical)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (407) 540-1000
DR. DONALD PLUMLEY MD
Surgery (Pediatric Surgery)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (407) 540-1000
GABRIEL JOSE RAMOS-GONZALEZ M.D.
Surgery (Pediatric Surgery)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (407) 540-1000
EMILY ROSE ULLOA PA
Physician Assistant (Surgical)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (407) 540-1000

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 Dominguez's NPI number?

The NPI number for Michelle Dominguez is 1679458137. It was assigned to this individual provider in the NPPES registry on August 6, 2025.

Where is Michelle Dominguez located?

Michelle Dominguez practices at 1720 S Orange Ave Ste 500, Orlando, FL 32806. The listed phone number is (407) 540-1616.

What is Michelle Dominguez's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Michelle Dominguez enrolled in Medicare?

Yes. Michelle Dominguez 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 Dominguez was last updated on January 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.