Individual provider Active NPI

Leydi Dominguez, ARNP

  • Family Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1871039115
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9380442 Issued in FL
Practice address
3592 Aloma Ave Ste 5
Winter Park, FL 32792-4012
Phone
(571) 230-3394
NPI assigned
Jan 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9380442 FL Primary

Addresses

Primary practice location

3592 Aloma Ave Ste 5
Winter Park, FL 32792-4012

Mailing address

3592 Aloma Ave Ste 5
Winter Park, FL 32792-4012
Phone (571) 230-3394

Other practice location 1

115 E Lancaster Rd Ste B
Orlando, FL 32809-6689
Phone (978) 760-9921

Other practice location 2

5454 27th Pl SW
Naples, FL 34116-7514
Phone (978) 760-9921

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190311002890 FL Practitioner - Nurse Practitioner 9436419744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3592 Aloma Ave
Suite 5
Winter Park, FL 32792-4012
Phone (407) 960-1413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9380442FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Health Clinic Corp CurrentSince Jun 15, 2019 Accepting new patients
Bright Clarity Mental Health LLC Current Accepting new patients

Locations

3592 Aloma Ave
Ste 5
Winter Park, FL 32792
Phone (407) 671-7141

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": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1871039115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3592 ALOMA AVE STE 5",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924012",
            "telephone_number": "571-230-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3592 ALOMA AVE STE 5",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924012",
            "telephone_number": "571-230-3394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 E Lancaster Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328096689",
            "country_code": "US",
            "telephone_number": "978-760-9921",
            "fax_number": "407-730-4606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5454 27th Pl SW",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341167514",
            "country_code": "US",
            "telephone_number": "978-760-9921",
            "fax_number": "407-730-4606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "LEYDI",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9380442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.