Individual provider Active NPI

Gloria Suja Domingo, MD

  • Pediatrics Physician
  • Linthicum, MD
National Provider Identifier
1679521975
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D26491 Issued in MD
Practice address
809 N Hammonds Ferry Rd Ste C
Linthicum, MD 21090
Phone
(410) 789-2500
Fax
(410) 789-2501
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D26491 MD Primary

Addresses

Primary practice location

809 N Hammonds Ferry Rd Ste C
Linthicum, MD 21090

Mailing address

809 N Hammonds Ferry Rd Ste C
Linthicum, MD 21090
Phone (410) 789-2500

Other identifiers 1

IdentifierTypeStateIssuer
270871001MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D26491MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Healthcare, LLC Pediatrics PastSince Sep 1, 2007 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679521975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 N HAMMONDS FERRY RD STE C",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "21090",
            "telephone_number": "410-789-2500",
            "fax_number": "410-789-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N HAMMONDS FERRY RD STE C",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "21090",
            "telephone_number": "410-789-2500",
            "fax_number": "410-789-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "GLORIA",
        "middle_name": "SUJA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D26491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270871001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Linthicum, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.