Minerva Domingo, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

157601 Issued in MA

Practice address

20 Research PL
N Chelmsford, MA 01863-2454

Phone

(978) 788-7307

Fax

(978) 788-7890

NPI assigned

Aug 9, 2005

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 21

Medicare fee-for-service enrollment

Enrolled in MA

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

Obstetrics/Gynecology

Education

Other, 1976

Medicare assignment

May accept Medicare assignment

Group practices

Circle Health OBGYN, LLC.Group PAC ID 1052483476, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lowell General Hospital Hospital, Lowell, MA, CCN 220063

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: minerva.domingo@womanhealth.circlehealthdirect.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/d04f75c7-2a62-4686-b520-7bf0635f38f0/

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.

• Circle Health OBGYN, LLC.

  • Obstetrics & Gynecology Physician
  • North Chelmsford, MA
  • NPI 1912179870
  Medicare reassignment Care Compare group
• LGH Medical Group, Inc.

  • Hospitalist Physician
  • Lowell, MA
  • NPI 1174698385
  Medicare reassignment NPD
• LGH Physician Associates, Inc

  • Family Medicine Physician
  • Lowell, MA
  • NPI 1972596146
  NPD (past)
• LGH Professional Services LLC

  • Internal Medicine Physician
  • Lowell, MA
  • NPI 1417485541
  NPD (past)
• LGH Womanhealth

  • Obstetrics & Gynecology Physician
  • Chelmsford, MA
  • NPI 1467433359
  NPD (past)
• The Lowell General Hospital

  dba Lowell General Hospital

  • General Acute Care Hospital
  • Lowell, MA
  • NPI 1407804669
  NPD (past)

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

• The Lowell General Hospital

  dba Lowell General Hospital

  • General Acute Care Hospital
  • Lowell, MA
  • NPI 1407804669
  Care Compare affiliation

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1639170210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PL STE 320",
            "city": "N CHELMSFORD",
            "state": "MA",
            "postal_code": "018632455",
            "telephone_number": "978-256-1858",
            "fax_number": "978-788-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PL",
            "city": "N CHELMSFORD",
            "state": "MA",
            "postal_code": "018632454",
            "telephone_number": "978-788-7307",
            "fax_number": "978-788-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "MINERVA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "157601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3189198",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTH NET",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLANS INC",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "157601",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY START",
            "identifier": "37371",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J19862",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "45016",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "136878",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "131062",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "157601",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "2636907",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0025776",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET OF CA",
            "identifier": "1639170210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK",
            "identifier": "981061",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelmsford Family Counseling Center
• Chelmsford Surgery Center LLC
• Olga Cobozeva, PMHNP-BS
• Kathleen Cullen-Lutter, RN/NM
• Brian Cullingford, M.D.
• Eric Joseph Ewald, MD
• Kailey Teresa Fasugba, LMHC
• Karen Fortune, MD
• Carol A Gagne, NP
• Elisabeth Rosl Gennis, MD

• Specialist in N Chelmsford, MA
• Providers in N Chelmsford, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.