Individual provider Active NPI

Elizabeth Maria Dominguez, CRNA

  • Certified Registered Nurse Anesthetist
  • Hialeah, FL
National Provider Identifier
1609851955
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP2617482 Issued in FL
Practice address
230 West 32 St.
Hialeah, FL 33012
Phone
(305) 753-4525
NPI assigned
Dec 9, 2005
Last updated
May 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP2617482 FL Primary

Addresses

Primary practice location

230 West 32 St.
Hialeah, FL 33012

Mailing address

230 West 32 St
Hialeah, FL 33012
Phone (305) 753-4525

Other identifiers 2

IdentifierTypeStateIssuer
306665700MedicaidFL
G3631OtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050125000145 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921058389 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulfstream Anesthesia Group LLCGroup PAC ID 7416028725, 19 clinicians
Gastro Anesthesia Services LLCGroup PAC ID 8628347101, 3 clinicians

Practice addresses (Care Compare)

2140 W 68 St
Suite 102
Hialeah, FL 33016-1815
Phone (305) 822-4107

7887 N Kendall Dr
Suite 101
Miami, FL 33156-7494
Phone (305) 273-6266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gulfstream Anesthesia Group LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 24, 2014 Accepting new patients

Locations

2140 W 68th St
Ste 102
Hialeah, FL 33016
Phone (305) 822-4107

2140 W 68th St
Ste 305
Hialeah, FL 33016
Phone (305) 822-4107

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1609851955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 WEST 32 ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33012",
            "telephone_number": "305-753-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 WEST 32 ST.",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33012",
            "telephone_number": "305-753-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "ELIZABETH",
        "middle_name": "MARIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP2617482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306665700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G3631",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.