Individual provider Active NPI

Lovelyn Caluya Dominguez, CRNP

  • Acute Care Nurse Practitioner
  • Bel Air, MD
National Provider Identifier
1316405772
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R156404 Issued in MD
Practice address
500 Upper Chesapeake Dr
Bel Air, MD 21014-4324
Phone
(443) 643-1000
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R156404 MD
Acute Care Nurse Practitioner 363LA2100X R156404 MD Primary

Addresses

Primary practice location

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324

Mailing address

3527 Fieldcreek Way
Parkville, MD 21234-3411
Phone (443) 519-9027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20200123002044 MD Practitioner - Nurse Practitioner 5991130700 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

3701 N Charles St
South Chapman Building Suite 102
Towson, MD 21204-6808

6535 N Charles St
Baltimore, MD 21204-5822

6565 N Charles St
Baltimore, MD 21204-6808

6569 N Charles St
Suite 505
Baltimore, MD 21204-6808
Phone (443) 849-2658

6569 N Charles St PPW Room
307 GYN Specialists
Baltimore, MD 21204-6808
Phone (443) 849-6123

6569 N Charles Street
504 Hoover Low Vision GBMC
Baltimore, MD 21204-6808
Phone (443) 849-2658

6701 N Charles St
Baltamore, MD 21204-6808

6701 N Charles St BLDG
S Chapman BLDG Suite 102
Baltimore, MD 21204-6808

6701 N Charles St Unit
Baltimore, MD 21204-6808
Phone (443) 849-3131

Hospital & facility affiliations

  • Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R156404MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Chesapeake Medical Services, Inc CurrentSince Nov 6, 2019 Accepting new patients
Greater Baltimore Medical Center, Inc. Acute Care CurrentSince Sep 7, 2021 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Sep 7, 2021 Accepting new patients

Locations

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

501 S Union Ave
Hvre de Grace, MD 21078
Phone (301) 939-2400

6535 N Charles St
Ste 125
Towson, MD 21204
Phone (443) 849-3779

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1316405772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 FIELDCREEK WAY",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212343411",
            "telephone_number": "443-519-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-643-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "LOVELYN",
        "middle_name": "CALUYA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R156404",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R156404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.