Gloria Eden Guerrero Domingo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13656 Issued in HI

Practice address

94-239 Waipahu Depot St Ste 110
Waipahu, HI 96797-3056

Phone

(808) 677-5664

Fax

(808) 677-1010

NPI assigned

Dec 28, 2010

Last updated

Oct 31, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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 HI

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

Specialty

Family Practice

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
• Pali Momi Medical Center Hospital, Aiea, HI, CCN 120026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Interoperability endpoints

• Direct secure messaging: gloria.domingo@193230584217604.direct.elationemr.com

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

• Gloria Eden G Domingo MD LLC

  • Primary Care Clinic/Center
  • Waipahu, HI
  • NPI 1194409284
  Medicare reassignment NPD Authorized official
• CMC Housestaff

  dba St Vincents Catholic Medical Center

  • Family Medicine Physician
  • Elmhurst, NY
  • NPI 1063572212
  NPD (past)

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

• Pali Momi Medical Center

  • General Acute Care Hospital
  • Aiea, HI
  • NPI 1013961408
  Care Compare affiliation
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1205130655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-239 WAIPAHU DEPOT ST STE 110",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973056",
            "telephone_number": "808-677-5664",
            "fax_number": "808-677-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-239 WAIPAHU DEPOT ST STE 110",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973056",
            "telephone_number": "808-677-5664",
            "fax_number": "808-677-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "GLORIA EDEN",
        "middle_name": "GUERRERO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "13656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Iris Galvez Dizon, PT
• DME Hawaii Corporation
• David DO
• Lisa DO, DMD
• Lawrence Kevin Dolan, LCSW
• Iluminada Peralta Domingo, CNA
• Kris Marie Domingo, PMHNP-BC
• Melody Domingo
• Don Quijote (USA) Co., LTD. (Don Quijote Drugs)
• Don Quijote (USA) Co.,LTD (Don Quijote Drugs)

• Family Medicine Physician in Waipahu, HI
• Providers in Waipahu, HI by specialty
• Family Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.