Dominique Gagne, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

50171 Issued in AZ

Practice address

111 E Dunlap Ave Ste 1-482
Phoenix, AZ 85020-7806

Phone

(602) 609-2600

Fax

(602) 609-2601

NPI assigned

Jun 20, 2016

Last updated

Oct 14, 2020By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Critical Care (Intensivists)Also: Pulmonary Disease

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arizona Critical Care Specialist, LLCGroup PAC ID 0749608719, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arizona Critical Care Specialists, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1770192437
  Medicare reassignment Care Compare group NPD
• Honorhealth

  dba HonorHealth John C. Lincoln Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  NPD (past)
• Valley Rheumatology PC

  dba Scottsdale Rheumatology Center

  • Rheumatology Physician
  • Scottsdale, AZ
  • NPI 1679298772
  NPD (past)

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

• Honorhealth

  dba HonorHealth John C. Lincoln Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1528418696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E DUNLAP AVE STE 1-482",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850207806",
            "telephone_number": "602-609-2600",
            "fax_number": "602-609-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E DUNLAP AVE STE 1-482",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850207806",
            "telephone_number": "602-609-2600",
            "fax_number": "602-609-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE",
        "first_name": "DOMINIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AZ",
            "license": "50171",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "50171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204096",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z246972",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tal Shlomo Gafni, DMD
• Karen Gage, PSY.D., LMFT
• Mally Gage, PHARMD, RPH
• Sandra L Gage, MD
• Ronald Anthony Gagliano Jr., M.D.
• Mary Sharyle Gagnepain, SLP
• Charles E Gagnon, D.O.
• Cindy Bartlett Gagnon
• Erik Michael Gagnon
• Grace Gagnon

• Pulmonary Disease Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pulmonary Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.