Alodia Banuelos Domingo, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP5625 Issued in AZ

Practice address

5700 W Olive Ave Ste 102
Glendale, AZ 85302

Phone

(623) 738-6062

Fax

(602) 354-9462

NPI assigned

Feb 26, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Alodia Banuelos Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alodia.domingo.p1@direct.nachci.nextgenshare.com

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.

• Arizona Essential Holistic Care

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1497246482
  Medicare reassignment NPD Authorized official
• Touchstone Behavioral Health

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1629541479
  Medicare reassignment NPD
• Our Family Healthcare

  • Family Nurse Practitioner
  • Glendale, AZ
  • NPI 1124846415
  NPD Authorized official
• Clinical Associates of Arizona LLC

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1265037485
  NPD
• Touchstone Behavioral Health

  • Community/Behavioral Health Agency
  • Avondale, AZ
  • NPI 1861855702
  NPD

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1043635162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W OLIVE AVE STE 102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853023147",
            "telephone_number": "623-738-6062",
            "fax_number": "602-354-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W OLIVE AVE STE 102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85302",
            "telephone_number": "623-738-6062",
            "fax_number": "602-354-9462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 W Bell Rd Bldg B",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "85308",
            "country_code": "US",
            "telephone_number": "623-850-3622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7200 W Bell Rd Bldg B",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "85308",
            "country_code": "US",
            "telephone_number": "623-850-3622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9305 W Thomas Rd",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850373328",
            "country_code": "US",
            "telephone_number": "623-322-8906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "ALODIA",
        "middle_name": "BANUELOS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN135342",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALODIA",
            "last_name": "BANUELOS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nicole Anna Donley, PHARM.D

• Family Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.