Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MA PORTIA BERNADETTE GUCE DOMINGO DO
NPI 1700573722
Family Medicine in Bloomington, IL

Q: What is Ma Portia Bernadette Domingo's NPI number?

The NPI number for Ma Portia Bernadette Domingo is 1700573722. It was assigned to this individual provider in the NPPES registry on April 19, 2023. The provider is also known as Phoebe Domingo.

Q: What is Ma Portia Bernadette Domingo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since April 19, 2023PECOS Enrolled

1701 E COLLEGE AVE, BLOOMINGTON, IL 61704(309) 664-3000 Get Directions Write a Review

NPPES record last updated: September 3, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 3, 2026, Jul 12, 2023 (2 updates tracked since 2023).

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About Ma Portia Bernadette Guce Domingo Do NPPES

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

MA PORTIA BERNADETTE GUCE DOMINGO DO (NPI 1700573722) is an individual family medicine provider in Bloomington, Illinois, licensed in Illinois (036182000) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Mount Vernon.

NPPES Registry Identity

NPI1700573722

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameMA PORTIA BERNADETTE GUCE DOMINGOCredential: DO

Location Address1701 E COLLEGE AVEBloomington, IL 61704-2101

Mailing Address1701 E College AveBloomington, IL 61704-2101

Phone(309) 664-3000

Sole ProprietorNo

Enumeration DateApril 19, 2023

Last NPPES UpdateSeptember 3, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2026

✔ NPI 1700573722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036182000

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedNeuromusculoskeletal Medicine & OMMTaxonomy 204D00000X · License 036182000 (IL)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License OL61440780 (WA)

1701 E COLLEGE AVE, Bloomington, IL 61704

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Other Names 1

Other Name (5)Phoebe Domingo

Secondary Practice Location 1

Location 1819 S 13th StMount Vernon, WA 98274-4112 · Phone (360) 814-6230

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ma Portia Bernadette Guce Domingo Do 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61704 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 20

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

MS. MARY CLAIRE BILES PT, MDT

Physical Therapist