SASHA RENAE DOMERESE NP-C
NPI 1861956922
Nurse Practitioner in Clarksville, AR
About Sasha Renae Domerese Np-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SASHA RENAE DOMERESE NP-C (NPI 1861956922) is an individual nurse practitioner in Clarksville, Arkansas, licensed in Arkansas (A006062) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Clarksville, and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Location 1
Accepted 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
Sasha Renae Domerese Np-c 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.
Medicare Billing Reassignments
2Medicare enrollment records show Sasha Domerese reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Clarksville, AR 72830
- Reassigned Medicare billing, Arkansas enrollment
- 6 clinicians in this Medicare group
Clarksville, AR 72830
- Reassigned Medicare billing, Arkansas enrollment
- 102 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 72830 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 3
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CLARKSVILLE, AR 72830
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 Sasha Domerese's NPI number?
The NPI number for Sasha Domerese is 1861956922. It was assigned to this individual provider in the NPPES registry on January 23, 2019. The provider is also known as Sasha Renae Johnson.
Where is Sasha Domerese located?
Sasha Domerese practices at 25 Professional Park Dr, Clarksville, AR 72830. The listed phone number is (479) 705-8181.
What is Sasha Domerese's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Sasha Domerese enrolled in Medicare?
Yes. Sasha Domerese 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 Sasha Domerese's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sasha Domerese reassigns Medicare benefits to 2 organizations: Robert Frederick Noonan Jr MD PA (Clarksville, AR) and East Arkansas Emergency Physicians, PLLC (Clarksville, AR). 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 Sasha Domerese's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sasha Domerese accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Sasha Domerese 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 Sasha Domerese was last updated on August 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Sasha Renae Domerese, NP-C · NPI 1861956922
Nurse Practitioner physician in Clarksville, Arkansas. Individual provider, active in the CMS NPPES registry since January 23, 2019.
## Identity
- **NPI:** 1861956922 (Entity type: Individual)
- **Enumerated:** January 23, 2019
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** A006062 (Arkansas)
- **Sole proprietor:** No
## Practice location
- **Address:** 25 PROFESSIONAL PARK DR, Clarksville, AR 72830
- **Phone:** (479) 705-8181 · **Fax:** (479) 705-0041
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Robert Frederick Noonan Jr MD PA (NPI 1477512127, Clarksville, AR); East Arkansas Emergency Physicians, PLLC (NPI 1609259753, Clarksville, AR) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** August 11, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1861956922) · Data from the CMS NPPES public registry.