Lisa G Domino, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

002438 Issued in IA

Practice address

2510 SW White Birch Dr Ste 5
Ankeny, IA 50023-7171

Phone

(515) 450-1339

Fax

(515) 964-3277

NPI assigned

Jul 23, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Robb Schmidt, OD, PCGroup PAC ID 1850203191, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Robb Schmidt, OD, PC

  • Optometrist
  • Nevada, IA
  • NPI 1487634994
  Medicare reassignment Care Compare group NPD
• Domino Eye Care, PLLC

  • Optometrist
  • Ankeny, IA
  • NPI 1033637079
  NPD Authorized official

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124283767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 SW WHITE BIRCH DR STE 5",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500237171",
            "telephone_number": "515-450-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 SW WHITE BIRCH DR STE 5",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500237171",
            "telephone_number": "515-450-1339",
            "fax_number": "515-964-3277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5405 Mills Civic Pkwy",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "502665303",
            "country_code": "US",
            "telephone_number": "515-223-6207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINO",
        "first_name": "LISA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Eileen Rhodes Dimmick, AUD
• Kylee Dirks
• Averie Dobson
• Eli Owlynne Dohrn, TLMHC
• Domino Eye Care, PLLC
• Archie Mae Donahue-Kleffman, MS, T-LMHC
• Michael Donahue, M.ED., ATC, LAT
• Brad Dondlinger, RPH
• Carissa Donner, DPT
• Kathleen Ramona Doohen, D.C.

• Optometrist in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.