Individual provider Active NPI

Raquel Marie Dominico, NP-C

  • Nurse Practitioner
  • Lorain, OH
National Provider Identifier
1134944002
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0038086 Issued in OH
Practice address
3700 Kolbe Rd
Lorain, OH 44053-1611
Phone
(440) 960-4516
NPI assigned
Nov 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.0038086 OH Primary

Addresses

Primary practice location

3700 Kolbe Rd
Lorain, OH 44053-1611

Mailing address

3600 Jaeger Rd Apt 1202
Lorain, OH 44053-5420
Phone (440) 320-6817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IL, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250214001839 OH Practitioner - Nurse Practitioner 4385174788 Reassigns benefits to 5 organizations
I20260220001788 IL Practitioner - Nurse Practitioner 4385174788 Reassigns benefits to 1 organization
I20260401000267 WA Practitioner - Nurse Practitioner 4385174788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0038086OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospitalist, LLC CurrentSince Mar 1, 2025 Accepting new patients
Allen Emergency Physicians, LLC CurrentSince Feb 1, 2025 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Apr 1, 2025 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jan 11, 2026 Accepting new patients
Hni Medical Services of Ohio, LLC CurrentSince Jan 28, 2025 Accepting new patients
Lorain Emergency Physicians, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

200 W Lorain St
Oberlin, OH 44074
Phone (440) 775-1211

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1134944002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 JAEGER RD APT 1202",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440535420",
            "telephone_number": "440-320-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICO",
        "first_name": "RAQUEL",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0038086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.