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DR. LIEZL TERSOL DOMINGO M.D.
NPI 1871880849
Pediatrics - Pediatric Cardiology in Augusta, GA

Active since June 28, 2011PECOS EnrolledAccepts Medicare Assignment
1120 15TH ST, AUGUSTA, GA 30912(706) 721-8623 Get Directions Write a Review

NPPES record last updated: December 20, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 20, 2021, May 3, 2018 (2 updates tracked since 2018).

About Dr. Liezl Tersol Domingo M.d. NPPES

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

DR. LIEZL TERSOL DOMINGO M.D. (NPI 1871880849) is an individual pediatric cardiology provider in Augusta, Georgia, licensed in Georgia (079825) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS, maintains a secondary practice location in Chicago, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1871880849
Entity TypeIndividualFemale
Primary Taxonomy2080P0202X
Provider Legal NameDR. LIEZL TERSOL DOMINGOCredential: M.D.
Location Address1120 15TH STAugusta, GA 30912-7232
Mailing Address1499 Walton Way Ste 1400Augusta, GA 30901-2603 · (706) 724-6100
Phone(706) 721-8623
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateJune 28, 2011
Last NPPES UpdateDecember 20, 20212 updates tracked since enumeration
NPPES CertifiedDecember 20, 2021
✔ NPI 1871880849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in GA · 079825
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1120 15TH ST, Augusta, GA 30912
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Secondary Practice Location 1

Location 11740 W Taylor StChicago, IL 60612-7232 · Phone (866) 600-2273

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

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

Dr. Liezl Tersol Domingo M.d. 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 ID7517184930
PECOS Enrollment IDI20211213000118
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 20

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

DR. TOYA HESTER KELLEY MD
Family Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-3157
DR. JACK BRADLEY ELLIS D.O.
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
MR. ROBERT SCOTT SMITH FNP-C
Nurse Practitioner (Family)
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8549
SAMI MOHAMMED ALSHEHRY
Student in an Organized Health Care Education/Training Program
1120 15TH ST, 1065
AUGUSTA, GA 30912
Richmond County (706) 721-2411
LUIS ALBERTO VELASQUEZ ZARATE M.D
Pathology (Anatomic Pathology & Clinical Pathology)
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-2771
DR. BRYAN RICHARD BROACH M.D.
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
JANELLE MCGILL M.D.
Pediatrics
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
DR. KAYLA ASHLEY SHAHBAZIAN DO
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623

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 Liezl Domingo's NPI number?

The NPI number for Liezl Domingo is 1871880849. It was assigned to this individual provider in the NPPES registry on June 28, 2011.

Where is Liezl Domingo located?

Liezl Domingo practices at 1120 15th St, Augusta, GA 30912. The listed phone number is (706) 721-8623.

What is Liezl Domingo's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Liezl Domingo enrolled in Medicare?

Yes. Liezl Domingo 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.

What insurance does Liezl Domingo accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Liezl Domingo 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 Liezl Domingo was last updated on December 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.