DR. LIEZL TERSOL DOMINGO M.D.
NPI 1871880849
Pediatrics - Pediatric Cardiology in Augusta, GA
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
Specialties & Licenses 2
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
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.
Medicare Billing Reassignment
Medicare enrollment records show Liezl Domingo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sandy, UT 84092
- Reassigned Medicare billing, Utah enrollment
- 751 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.
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.
AUGUSTA, GA 30912
AUGUSTA, GA 30912
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.
Which organization bills Medicare for Liezl Domingo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Liezl Domingo reassigns Medicare benefits to University Of Utah Pediatric Services (Sandy, UT). 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 Liezl Domingo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Dr. Liezl Tersol Domingo, M.D. · NPI 1871880849
Pediatric Cardiology physician in Augusta, Georgia. Individual provider, active in the CMS NPPES registry since June 28, 2011.
## Identity
- **NPI:** 1871880849 (Entity type: Individual)
- **Enumerated:** June 28, 2011
- **Primary specialty:** Pediatrics - Pediatric Cardiology · taxonomy 2080P0202X
- **State license:** 079825 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1120 15TH ST, Augusta, GA 30912-7232
- **Phone:** (706) 721-8623
## 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:** University Of Utah Pediatric Services (NPI 1386257152, Sandy, UT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** December 20, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1871880849) · Data from the CMS NPPES public registry.