Susan E. Domingue, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1030762 Issued in MA

Practice address

363 Highland Ave.
Southcoast Center for Cancer Care
Fall River, MA 02720

Phone

(508) 679-7814

Fax

(508) 679-7881

NPI assigned

Dec 24, 2009

Last updated

Dec 24, 2009By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629
  Medicare reassignment Care Compare group NPD
• Southcoast Physicians Group, Inc.

  dba Southcoast Urgent Care Center

  • Emergency Medicine Physician
  • Fairhaven, MA
  • NPI 1861830143
  NPD
• Southcoast Physicians Group, Inc.

  • Orthopaedic Surgery Physician
  • North Dartmouth, MA
  • NPI 1902201536
  NPD

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261612800000",
    "number": "1740519651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 HIGHLAND AVE.",
            "address_2": "SOUTHCOAST CENTER FOR CANCER CARE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02720",
            "telephone_number": "508-679-7814",
            "fax_number": "508-679-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 HIGHLAND AVE.",
            "address_2": "SOUTHCOAST CENTER FOR CANCER CARE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02720",
            "telephone_number": "508-679-7814",
            "fax_number": "508-679-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUE",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-24",
        "last_updated": "2009-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1030762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boris Dov Djerassi, DC
• Marcellene S Doctor, M.D.
• Sophia C Doely, LPN
• Richard Doherty
• Adryon Domenico, MFTI
• Erik Domingues, MD
• Jacob Anthony Dominguez-Garcia
• Eric Dominguez, MD
• Dominion Diagnostics, LLC
• Jennifer Marie Domonte

• Clinical Social Worker in Fall River, MA
• Providers in Fall River, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2009; 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.