Individual provider Active NPI

Michelle C Domingo, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1487362125
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F350737 Issued in NY
Practice address
4770 White Plains Rd
Bronx, NY 10470-1136
Phone
(646) 289-5357
NPI assigned
Nov 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F350737 NY Primary

Addresses

Primary practice location

4770 White Plains Rd
Bronx, NY 10470-1136

Mailing address

4770 White Plains Rd
Bronx, NY 10470-1136
Phone (646) 289-5357

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221229001458 NY Practitioner - Nurse Practitioner 2769852169 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F350737NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
House Call Medical Services of New York, PLLC CurrentSince Nov 5, 2022 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Medical Director Services PC CurrentSince Dec 20, 2023 Accepting new patients
Essen Medical Associates,PC CurrentSince Nov 5, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Nov 5, 2022 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Nov 5, 2022 Accepting new patients
JDS Medical Services PC CurrentSince Dec 9, 2025 Accepting new patients
Terence Cardinal Cooke Health Care Center Past Accepting new patients

Locations

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1487362125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701136",
            "telephone_number": "646-289-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701136",
            "telephone_number": "646-289-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "MICHELLE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-11",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F350737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.