Individual provider Active NPI

Kelly Dominici

  • Clinical Social Worker
  • Fremont, CA
National Provider Identifier
1851527105
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2296 Country Dr
Fremont, CA 94536-5315
Phone
(510) 608-3733
NPI assigned
Jun 1, 2009
Last updated
Jun 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PA Primary

Addresses

Primary practice location

2296 Country Dr
Fremont, CA 94536-5315

Mailing address

2296 Country Dr
Fremont, CA 94536
Phone (510) 608-3733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20260109000815 NJ Practitioner - Clinical Social Worker 7416433420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Helene Miller MD LLCGroup PAC ID 8224465927, 9 clinicians

Practice addresses (Care Compare)

351 Evelyn St
Paramus, NJ 07652-2901
Phone (201) 977-2889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Helene Miller, MD, LLC CurrentSince Nov 1, 2025 Accepting new patients

Locations

17 Arcadian Way
Ste 108
Paramus, NJ 07652
Phone (201) 316-5581

351 Evelyn St
Paramus, NJ 07652
Phone (201) 265-1300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1851527105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2296 COUNTRY DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94536",
            "telephone_number": "510-608-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 COUNTRY DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365315",
            "telephone_number": "510-608-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICI",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.