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MRS. KIMBERLY IRBY DOMINIQUE FNP
NPI 1902496524
Nurse Practitioner - Family in Pascagoula, MS

Active since January 19, 2021PECOS EnrolledAccepts Medicare Assignment
4310 CHICOT ST, PASCAGOULA, MS 39581(228) 205-4737(228) 205-4964 Get Directions Write a Review

NPPES record last updated: January 19, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mrs. Kimberly Irby Dominique Fnp NPPES

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

MRS. KIMBERLY IRBY DOMINIQUE FNP (NPI 1902496524) is an individual family provider in Pascagoula, Mississippi, licensed in Mississippi (904287) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital At Gulfport, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1902496524
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. KIMBERLY IRBY DOMINIQUECredential: FNP
Location Address4310 CHICOT STPascagoula, MS 39581-4700
Mailing Address3709 Oak AveGulfport, MS 39507-3108 · (228) 596-5301
Phone(228) 205-4737
Fax(228) 205-4964
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 19, 2021
NPPES CertifiedJanuary 19, 2021
✔ NPI 1902496524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MS · 904287
4310 CHICOT ST, Pascagoula, MS 39581
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health 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 and accepts Medicare assignment

Mrs. Kimberly Irby Dominique Fnp 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 ID9638576788
PECOS Enrollment IDI20210916001822
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

3

Medicare enrollment records show Kimberly Dominique reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Memorial Hospital At Gulfport
25 mi
General Acute Care Hospital
1720B MEDICAL PARK DR
Biloxi, MS 39532
  • Reassigned Medicare billing, Mississippi enrollment
  • 731 clinicians in this Medicare group
NPI 1215546635 (228) 702-2000
Forever Young Mens Health Clinic PLLC
30 mi
Endocrinology, Diabetes & Metabolism
8837 LORRAINE RD STE B
Gulfport, MS 39503
  • Reassigned Medicare billing, Mississippi enrollment
  • 3 clinicians in this Medicare group
NPI 1114503190 (228) 669-7293
Gulf Coast Wound Associates LLC
51 mi
Wound Care
5427 GEX RD
Diamondhead, MS 39525
  • Reassigned Medicare billing, Mississippi enrollment
  • 15 clinicians in this Medicare group
NPI 1467118448 (228) 255-4832

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 moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
135 services82 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
70 services64 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
54 services28 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.
41 services35 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital At Gulfport

Acute Care Hospitals · Gulfport, MS
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number250019
Location4500 13th StreetGulfport, MS 39502 · Harrison County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39581 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
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 2

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

PHYSICIANS CARE PLAZA
Durable Medical Equipment & Medical Supplies
4310 CHICOT ST
PASCAGOULA, MS 39581
Jackson County (228) 205-0617
BAZ FAMILY MEDICAL CLINIC
Family Medicine
4310 CHICOT ST
PASCAGOULA, MS 39581
Jackson County (717) 421-5490

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 Kimberly Dominique's NPI number?

The NPI number for Kimberly Dominique is 1902496524. It was assigned to this individual provider in the NPPES registry on January 19, 2021.

Where is Kimberly Dominique located?

Kimberly Dominique practices at 4310 Chicot St, Pascagoula, MS 39581. The listed phone number is (228) 205-4737.

What is Kimberly Dominique's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kimberly Dominique enrolled in Medicare?

Yes. Kimberly Dominique 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 Kimberly Dominique's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Dominique reassigns Medicare benefits to 3 organizations: Memorial Hospital At Gulfport (Biloxi, MS), Forever Young Mens Health Clinic PLLC (Gulfport, MS) and Gulf Coast Wound Associates LLC (Diamondhead, MS). 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 Kimberly Dominique's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Dominique accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Kimberly Dominique 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.

Is Kimberly Dominique affiliated with any hospitals?

According to CMS data, Kimberly Dominique is affiliated with Memorial Hospital At Gulfport.

When was this NPI record last updated?

The NPPES record for Kimberly Dominique was last updated on January 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.