Cecilia M Dominguez, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60666459 Issued in WA

Practice address

2101 NE 139TH St Ste 265
Vancouver, WA 98686-2311

Phone

(360) 487-2700

Fax

(360) 487-2701

NPI assigned

Mar 11, 2009

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

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians

Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

Merit-based Incentive Payment System (MIPS)

Final score

92.83 of 100Reported as group

Quality

96.26

Promoting interoperability

100

Improvement activities

40

Cost

79.84

Merit-based Incentive Payment System (MIPS)

Final score

92.34 of 100Reported as group

Quality

92.55

Promoting interoperability

100

Improvement activities

40

Cost

76.53

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cdominguez144537@direct.lhs.org

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.

• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784
  Medicare reassignment Care Compare group NPD
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Medicare reassignment Care Compare group NPD
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD
• Legacy Good Samaritan Hospital and Medical Center

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1609896174
  NPD
• Legacy Good Samaritan Hospital and Medical Center

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108
  NPD

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

• Legacy Good Samaritan Hospital and Medical Center

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Care Compare affiliation

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1174764732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 E 2ND ST APT 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900333960",
            "telephone_number": "415-515-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST STE 265",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862311",
            "telephone_number": "360-487-2700",
            "fax_number": "360-487-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "CECILIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2673",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60666459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William K. Domarad, D.O.
• Michael Dennis Domash, M.D.
• Joseph Connor Domek, DPT
• Anthony Joseph Domenigoni, D.P.M.
• Ashley J Domingo, RN
• Karina Dominguez
• Kelly Rae Dominici, LCSW
• Ruth E Don, LMP
• Todd Allen Dona, RN
• Geni Donaghey, M.S.-CCC/SLP

• Clinical Psychologist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.