Individual provider Active NPI

Vinicius Costa Diniz Domingues, M.D.

  • Rheumatology Physician
  • Daytona Beach, FL
National Provider Identifier
1023364387
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
ME130111 Issued in FL
Practice address
709 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603
Phone
(386) 252-1632
Fax
(386) 257-5526
NPI assigned
Jul 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X ME130111 FL Primary

Addresses

Primary practice location

709 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603

Mailing address

709 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603
Phone (386) 252-1632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170802000489 FL Practitioner - Rheumatology 0244501757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael D. Kohen MD PAGroup PAC ID 1557395670, 3 clinicians

Practice addresses (Care Compare)

709 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603
Phone (386) 252-1632

Hospital & facility affiliations

  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
  • Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME130111FLMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael D. Kohen, MD, PA Rheumatology CurrentSince Jul 10, 2017 Accepting new patients

Locations

709 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 252-1632

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1023364387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141603",
            "telephone_number": "386-252-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141603",
            "telephone_number": "386-252-1632",
            "fax_number": "386-257-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA DINIZ DOMINGUES",
        "first_name": "VINICIUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "ME130111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.