Maritza Dominguez, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F303551 Issued in NY

Practice address

101 S Bergen Place
Freeport, NY 11520

Phone

(516) 623-3600

Fax

(516) 623-9191

NPI assigned

Jan 3, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harmony Health Care Long IslandGroup PAC ID 5991970535, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: maritza.dominguez@lifqhc.eclinicaldirectplus.com

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.

• Harmony Health Care Long Island

  • Federally Qualified Health Center (FQHC)
  • Elmont, NY
  • NPI 1336669670
  Medicare reassignment Care Compare group NPD
• Harmony Health Care Long Island

  • Federally Qualified Health Center (FQHC)
  • North Baldwin, NY
  • NPI 1205704319
  NPD
• Harmony Health Care Long Island

  • Federally Qualified Health Center (FQHC)
  • Westbury, NY
  • NPI 1215241302
  NPD
• Elmont Community Health Center

  • Clinic/Center
  • Elmont, NY
  • NPI 1467478362
  NPD (past)
• South Ocean Care LLC

  • Clinic/Center
  • Freeport, NY
  • NPI 1205811049
  NPD (past)

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1457339202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 NASSAU RD",
            "address_2": "LONG ISLAND FQHC, INC.",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751343",
            "telephone_number": "516-571-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S BERGEN PLACE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "11520",
            "telephone_number": "516-623-3600",
            "fax_number": "516-623-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MARITZA",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02481836",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Devarso, CPNP
• Muadh M Diaab
• Juan Carlos Diaz, CASAC
• Valerie Faye Dipinto
• Dmemd Inc
• Rebecca Rose Dominguez, LMSW
• Sara A Dominguez
• Caitlin M. Dorn, LCSW
• Cherise Dorsey, RN
• Deshanti T Dortch

• Adult Health Nurse Practitioner in Freeport, NY
• Providers in Freeport, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.