Elizabeth Anne Dominguez, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1910 Issued in OR

Practice address

2073 Olympic St
Springfield, OR 97477-3413

Phone

(541) 682-3550

NPI assigned

Oct 19, 2012

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 OR

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 Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lane County OregonGroup PAC ID 7416853833, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabeth.dominguez.p1@direct.lanecounty.nextgenshare.com

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.

• Lane County Oregon

  • Federally Qualified Health Center (FQHC)
  • Springfield, OR
  • NPI 1326138314
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1801149471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 OLYMPIC ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773413",
            "telephone_number": "541-682-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2073 OLYMPIC ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773413",
            "telephone_number": "541-682-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Dawn Dodd, PA-C
• Christine M Dodson, RN
• David Andrew Dodson, MA QMHP
• Kristen Doecke, LPC
• Cassandra Domask
• Norma A. Dominguez
• Erica Donnan, MD
• Michael David Donnan, MD
• Cindy Louise Donner, LPN
• Christopher Doremus

• Psychologist in Springfield, OR
• Providers in Springfield, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; 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.