Tracie Tue Dominguez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1650 Cochrane Cir
Fort Carson, CO 80913-4603

Phone

(719) 244-2286

NPI assigned

Oct 27, 2009

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 CO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Post Acute Rehabilitation Physicians LLCGroup PAC ID 7214334614, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Post Acute Rehabilitation Physicians LLC

  • Physical Medicine & Rehabilitation Physician
  • Lehi, UT
  • NPI 1023781028

  CO

  Medicare reassignment Care Compare group NPD
• Santa Fe Trail Senior Services Inc

  dba Home Well Care Services

  • In Home Supportive Care Agency
  • Colorado Springs, CO
  • NPI 1073112207
  NPD Authorized official
• RFH Colorado, LLC

  • Rheumatology Physician
  • Thornton, CO
  • NPI 1447081229
  NPD (past)

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1790011757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 BARNSTORMERS AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809111214",
            "telephone_number": "808-352-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134603",
            "telephone_number": "719-244-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "TRACIE",
        "middle_name": "TUE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-27",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lourdes M. Diaz, LPC, CAC III
• Chelsea Ann Dill, SLP
• Vanessa Lynn Dill, LMSW
• Jay Francis Dingbaum, CRNA
• Shirley Ann Dollesin, LPC
• Davina L Donaldson Hawkins, LMFT
• Edward Lee Donaldson, DDS
• Richard Benjamin Dones, LCSW
• Maria Doran
• Zachary Dotson

• Physician Assistant in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.