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JOHANNY LOPEZ DOMINGUEZ MD
NPI 1972187086
Student in an Organized Health Care Education/Training Program in Orlando, FL

Active since May 06, 2021PECOS Enrolled
52 W UNDERWOOD ST, ORLANDO, FL 32806(321) 841-5145 Get Directions Write a Review

NPPES record last updated: June 14, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Johanny Lopez Dominguez Md NPPES

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

JOHANNY LOPEZ DOMINGUEZ MD (NPI 1972187086) is an individual student in an organized health care education/training program in Orlando, Florida, licensed in Florida (35293) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS and is a graduate of Mayo Medical School (2022).

NPPES Registry Identity

NPI1972187086
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJOHANNY LOPEZ DOMINGUEZCredential: MD
Location Address52 W UNDERWOOD STOrlando, FL 32806-1110
Mailing Address9745 Touchton Rd Unit 1530Jacksonville, FL 32246-1513
Phone(321) 841-5145
Sole ProprietorNo
Medical School CMSMayo Medical SchoolGraduated 2022
Enumeration DateMay 6, 2021
Last NPPES UpdateJune 14, 2022
NPPES CertifiedJune 14, 2022
✔ NPI 1972187086 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in FL · 35293
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
52 W UNDERWOOD ST, Orlando, FL 32806
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Johanny Lopez Dominguez Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5890175772
PECOS Enrollment IDI20251125001590
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 Reassignment

Medicare enrollment records show Johanny Lopez Dominguez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
2,382 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000

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.

MANDIP KAUR ARNP
Nurse Practitioner (Psychiatric/Mental Health)
52 W UNDERWOOD ST
ORLANDO, FL 32806
Orange County (407) 262-2220
MS. HELEN F. PHIPPS NP
Nurse Practitioner
52 W UNDERWOOD ST
ORLANDO, FL 32806
Orange County (352) 343-1341
AMANDA GABRIELE HERMIDA RN
Nurse Anesthetist, Certified Registered
52 W UNDERWOOD ST
ORLANDO, FL 32806
Orange County (321) 841-5111
DR. JOSEPH N FOSS MD
Radiology (Diagnostic Radiology)
52 W UNDERWOOD ST
ORLANDO, FL 32806
Orange County (321) 842-8475
KRISHNA KUMAR D.O.
Radiology (Diagnostic Radiology)
52 W UNDERWOOD ST
ORLANDO, FL 32806
Orange County (321) 842-8475
SIMONE LEMAR GOWIE-JEROME ARNP
Nurse Practitioner (Family)
52 W UNDERWOOD ST
ORLANDO, FL 32806
Orange County (321) 841-6229
NUGMA CHADHA MD
Internal Medicine
52 W UNDERWOOD ST
ORLANDO, FL 32806
Orange County (321) 841-3581
DR. LARA WOLFENDEN AGACNP
Nurse Practitioner (Adult Health)
52 W UNDERWOOD ST
ORLANDO, FL 32806
Orange County (321) 841-5111

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 Johanny Lopez Dominguez's NPI number?

The NPI number for Johanny Lopez Dominguez is 1972187086. It was assigned to this individual provider in the NPPES registry on May 6, 2021.

Where is Johanny Lopez Dominguez located?

Johanny Lopez Dominguez practices at 52 W Underwood St, Orlando, FL 32806. The listed phone number is (321) 841-5145.

What is Johanny Lopez Dominguez's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Johanny Lopez Dominguez enrolled in Medicare?

Yes. Johanny Lopez Dominguez is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Johanny Lopez Dominguez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Johanny Lopez Dominguez reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). 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 Johanny Lopez Dominguez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Johanny Lopez Dominguez was last updated on June 14, 2022. 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.