Michele B Domico, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

A83525 Issued in CA

Practice address

455 S Main Street
Orange, CA 92868-3835

Phone

(714) 532-8620

Fax

(714) 289-4072

NPI assigned

Jun 25, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Critical Care (Intensivists)Also: Pediatric Medicine

Education

University of Texas Medical School at San Antonio, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childrens Hospital of Orange CountyGroup PAC ID 6406944883, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Children'S Hospital of Orange County

  dba CHOC Children's Specialists

  • Pediatrics Physician
  • Orange, CA
  • NPI 1275975104

  Pediatric Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Marilyn Kaufhold, M.D., a Medical Corporation

  • Children's Hospital
  • San Diego, CA
  • NPI 1336359389
  NPD (past)
• UC Regents Uci Dept of Pediatrics

  • Pediatrics Physician
  • Orange, CA
  • NPI 1235187311
  NPD (past)
• University of California Irvine

  dba UCI Infusion Center

  • Infusion Therapy Clinic/Center
  • Irvine, CA
  • NPI 1417027475
  NPD (past)

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932305000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683835",
            "telephone_number": "714-532-8620",
            "fax_number": "714-289-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN STREET",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683835",
            "telephone_number": "714-532-8620",
            "fax_number": "714-289-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMICO",
        "first_name": "MICHELE",
        "middle_name": "B",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A83525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A835250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doheny Eye Medical Group
• Thomas Wayne Dolan, CO
• Matthew Dolich, MD
• Dollys Angels Inc. (Homewatch CareGivers of Orange)
• Nancy Lee Tran Dom, M.D.
• Vanessa Domingue
• Caitlyn Rose Dominguez
• Chelsi Dominguez
• David Jr Dominguez
• Dianna Rose Dominguez

• Pediatric Critical Care Medicine Physician in Orange, CA
• Providers in Orange, CA by specialty
• Pediatric Critical Care Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.