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DR. OSVALDO ANTONIO FERNANDEZ DOMINGUEZ M.D.
NPI 1821310632
Psychiatry & Neurology - Child & Adolescent Psychiatry in Miami, FL

Active since February 20, 2010PECOS Enrolled
3621 SW 107TH AVE, MIAMI, FL 33165(855) 226-6633 Get Directions Write a Review

NPPES record last updated: January 9, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Osvaldo Antonio Fernandez Dominguez M.d. NPPES

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

DR. OSVALDO ANTONIO FERNANDEZ DOMINGUEZ M.D. (NPI 1821310632) is an individual child & adolescent psychiatry provider in Miami, Florida, licensed in Florida (ME106374) and active in the NPI registry since February 2010. He is enrolled in Medicare PECOS and is a graduate of Other (1985).

NPPES Registry Identity

NPI1821310632
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameDR. OSVALDO ANTONIO FERNANDEZ DOMINGUEZCredential: M.D.
Location Address3621 SW 107TH AVEMiami, FL 33165-3636
Mailing Address3621 Sw 107th AveMiami, FL 33165-3636 · (855) 226-6633
Phone(855) 226-6633
Sole ProprietorYes
Medical School CMSOtherGraduated 1985
Enumeration DateFebruary 20, 2010
Last NPPES UpdateJanuary 9, 2023
NPPES CertifiedJanuary 9, 2023
✔ NPI 1821310632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in FL · ME106374
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
3621 SW 107TH AVE, Miami, FL 33165
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Other Identifiers 1

Medicaid002095400FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, 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 (PECOS)

Dr. Osvaldo Antonio Fernandez Dominguez M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698806636
PECOS Enrollment IDI20100708000383
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 Reassignment

Medicare enrollment records show Osvaldo Fernandez Dominguez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Serenity Community Mental Health Center LLC
Same address
Mental Health (Including Community Mental Health Center)
3621 SW 107TH AVE
Miami, FL 33165
  • Reassigned Medicare billing, Florida enrollment
  • 18 clinicians in this Medicare group
NPI 1457705634 (786) 534-8366

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 4

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 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.
530 services204 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.
59 services34 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
38 services38 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
15 services15 patients

Other Providers at the Same Location NPPES 14

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

MR. EDDY ELOY QUINTANA CRUZ CBHCM100190
Social Worker
3621 SW 107TH AVE
MIAMI, FL 33165
Miami-Dade County (305) 302-1335
LEIDY RIVERO CARVAJAL
Nurse Practitioner (Psychiatric/Mental Health)
3621 SW 107TH AVE
MIAMI, FL 33165
Miami-Dade County (786) 534-8366
LAURA LUCAS
Nurse Practitioner (Psychiatric/Mental Health)
3621 SW 107TH AVE
MIAMI, FL 33165
Miami-Dade County (786) 534-8366
BEST FLORIDA REHABILITATION CENTER INC
Clinic/Center (Physical Therapy)
3621 SW 107TH AVE
MIAMI, FL 33165
Miami-Dade County (305) 223-0007
ROLANDO CASTILLO LMHC
Counselor (Mental Health)
3621 SW 107TH AVE
MIAMI, FL 33165
Miami-Dade County (305) 608-3383
ANIA K MOLINA PAZ APRN
Nurse Practitioner (Psychiatric/Mental Health)
3621 SW 107TH AVE
MIAMI, FL 33165
Miami-Dade County (561) 707-7607
MRS. MONICA JOANN BOSCH BATULE LCSW
Counselor (Mental Health)
3621 SW 107TH AVE
MIAMI, FL 33165
Miami-Dade County (786) 534-8366
EXCEPTIONAL REHAB
Occupational Therapist
3621 SW 107TH AVE
MIAMI, FL 33165
Miami-Dade County (305) 223-0007

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 Osvaldo Fernandez Dominguez's NPI number?

The NPI number for Osvaldo Fernandez Dominguez is 1821310632. It was assigned to this individual provider in the NPPES registry on February 20, 2010.

Where is Osvaldo Fernandez Dominguez located?

Osvaldo Fernandez Dominguez practices at 3621 SW 107th Ave, Miami, FL 33165. The listed phone number is (855) 226-6633.

What is Osvaldo Fernandez Dominguez's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Osvaldo Fernandez Dominguez enrolled in Medicare?

Yes. Osvaldo Fernandez Dominguez is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Osvaldo Fernandez Dominguez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Osvaldo Fernandez Dominguez reassigns Medicare benefits to Serenity Community Mental Health Center LLC (Miami, FL). The 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 Osvaldo Fernandez Dominguez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Osvaldo Fernandez Dominguez accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama and Oscar Health Maintenance Organization of Florida list Osvaldo Fernandez Dominguez 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.

When was this NPI record last updated?

The NPPES record for Osvaldo Fernandez Dominguez was last updated on January 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.