DR. CONNIE D DOMINGO MD
NPI 1902896889
Physical Medicine & Rehabilitation - Pediatric Rehabilitation Medicine in Marlton, NJ

Q: What is the provider's specialty?

The provider's specialty is Physical Medicine & Rehabilitation with taxonomy code 2081P0010X and a focus in Pediatric Rehabilitation Medicine.

Active since October 24, 2005PECOS Enrolled

92 BRICK RD, 3RD FLOOR, MARLTON, NJ 08053(856) 489-4520(856) 983-1065 Get Directions Write a Review

NPPES record last updated: February 16, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 21, 2026, Feb 27, 2017, Jan 9, 2017 (3 updates tracked since 2017).

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About Dr. Connie D Domingo Md NPPES

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

DR. CONNIE D DOMINGO MD (NPI 1902896889) is an individual pediatric rehabilitation medicine provider in Marlton, New Jersey, licensed in New Jersey (25MA06376400) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS and is a graduate of Other (1994).

NPPES Registry Identity

NPI1902896889

Entity TypeIndividualFemale

Primary Taxonomy2081P0010X

Provider Legal NameDR. CONNIE D DOMINGOCredential: MD

Location Address92 BRICK RD, 3RD FLOORMarlton, NJ 08053-2177

Mailing AddressPo Box 674Marlton, NJ 08053-0674 · (856) 489-4520 · Fax (856) 983-1065

Phone(856) 489-4520

Fax(856) 983-1065

Sole ProprietorNo

Medical School CMSOtherGraduated 1994

Enumeration DateOctober 24, 2005

Last NPPES UpdateFebruary 16, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 16, 2026

✔ NPI 1902896889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pediatric Rehabilitation MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2081P0010X

Licenses✔ Licensed in NJ · 25MA06376400✔ Licensed in NM · MD2026-0032

Definition

A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care.

92 BRICK RD, Marlton, NJ 08053

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Connie D Domingo Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476837386

PECOS Enrollment IDI20260318001771

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.