Karissa Marie Dominguez

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

XXXXXX Issued in OH

Practice address

1111 Hayes Ave
Sandusky, OH 44870-3323

Phone

(419) 573-3504

NPI assigned

May 24, 2024

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 OH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohio Anesthesia Group, IncGroup PAC ID 9537222138, 130 clinicians

Elyria Anesthesia IncorporatedGroup PAC ID 7214902170, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Firelands Regional Medical Center Hospital, Sandusky, OH, CCN 360025
• Mercy Regional Medical Center Hospital, Lorain, OH, CCN 360172
• Bellevue Hospital Hospital, Bellevue, OH, CCN 360107

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.

• Elyria Anesthesia Incorporated

  • Anesthesiology Physician
  • Elyria, OH
  • NPI 1710922463
  Medicare reassignment Care Compare group NPD
• Ohio Anesthesia Group, Inc

  • Anesthesiology Physician
  • Canton, OH
  • NPI 1639348113

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

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

• Firelands Regional Medical Center

  dba Firelands Counseling & Recovery Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tiffin, OH
  • NPI 1154372381

  Hospital

  Care Compare affiliation
• Firelands Regional Medical Center

  • General Acute Care Hospital
  • Sandusky, OH
  • NPI 1285392936
  Care Compare affiliation
• Firelands Regional Medical Center

  dba Firelands Counseling & Recovery Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sandusky, OH
  • NPI 1629028600

  Hospital

  Care Compare affiliation
• Firelands Regional Medical Center

  • General Acute Care Hospital
  • Sandusky, OH
  • NPI 1801884655
  Care Compare affiliation
• Firelands Regional Medical Center

  dba Firelands Counseling & Recovery Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norwalk, OH
  • NPI 1992756118

  Hospital

  Care Compare affiliation
• Mercy Health-Regional Medical Center LLC

  dba Mercy Regional Medical Center Laboratory

  • Clinical Medical Laboratory
  • Lorain, OH
  • NPI 1164971800

  Hospital

  Care Compare affiliation
• Mercy Health-Regional Medical Center LLC

  dba Mercy Health Lorain Hospital

  • General Acute Care Hospital
  • Lorain, OH
  • NPI 1245274950
  Care Compare affiliation
• The Bellevue Hospital

  • General Acute Care Hospital
  • Bellevue, OH
  • NPI 1134161623
  Care Compare affiliation

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1366281651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 WHITMAN BLVD",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440351726",
            "telephone_number": "440-541-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703323",
            "telephone_number": "419-573-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "KARISSA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "XXXXXX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Ditty, M.D.
• Marlita Divencenzo, OTR/L, CHT
• Kale Alexander Divers
• Rita Dodd, OTRL, CHT
• Mary Ann Dolsen
• Kelly M Donaldson, PT
• Brad Downing
• Dr. Eileen McGee & Associates, Inc.
• Dreffer, Hicks, & Demos OD Inc (Family Eye Care Centers)
• Tevin Drosky, MS,CDCA

• Certified Registered Nurse Anesthetist in Sandusky, OH
• Providers in Sandusky, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.