ANGEL L DOMINGUEZ LICSW
NPI 1891579827
Social Worker - Clinical in New Prague, MN

Q: What is Angel Dominguez's NPI number?

The NPI number for Angel Dominguez is 1891579827. It was assigned to this individual provider in the NPPES registry on August 21, 2023.

Q: What is Angel Dominguez's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Angel Dominguez was last updated on March 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since August 21, 2023PECOS EnrolledAccepts Medicare Assignment

301 2ND ST NE, NEW PRAGUE, MN 56071(952) 758-4431 Get Directions Write a Review

NPPES record last updated: March 19, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Angel L Dominguez Licsw NPPES

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

ANGEL L DOMINGUEZ LICSW (NPI 1891579827) is an individual clinical provider in New Prague, Minnesota, licensed in Minnesota (26733) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Davenport, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1891579827

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameANGEL L DOMINGUEZCredential: LICSW

Location Address301 2ND ST NENew Prague, MN 56071-1709

Mailing Address200 1st St SwRochester, MN 55905-0001 · (507) 284-2511

Phone(952) 758-4431

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateAugust 21, 2023

Last NPPES UpdateMarch 19, 2024

NPPES CertifiedMarch 19, 2024

✔ NPI 1891579827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Licenses✔ Licensed in MN · 26733✔ Licensed in IA · 082177

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

301 2ND ST NE, New Prague, MN 56071

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Secondary Practice Location 1

Location 11225 E River Dr Ste 330Davenport, IA 52803-5761 · Phone (563) 424-0136

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

Angel L Dominguez Licsw 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 ID7113365818

PECOS Enrollment IDI20240401001012

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 Reassignments

Medicare enrollment records show Angel Dominguez reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mayo Clinic Health System-Southwest Minnesota Region

Same address

Critical Access

301 2ND STREET NE
New Prague, MN 56071

Reassigned Medicare billing, Minnesota enrollment
Also billed through NPI 1477089407 (Minnesota)
639 clinicians in this Medicare group

NPI 1124035282 (952) 758-4431

Mayo Clinic Health System-Fairmont

76 mi

Multi-Specialty

800 MEDICAL CENTER DR
Fairmont, MN 56031

Reassigned Medicare billing, Minnesota enrollment
806 clinicians in this Medicare group

NPI 1366410862 (507) 238-8100

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 56071 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

$0.00 typical visit price

range $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

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.

CARLA SIMON OT

Occupational Therapist