Carl Joseph Domigan, NNP-BC is a medicare enrolled "Nurse Practitioner - Neonatal" physician in Detroit, Michigan. His current practice location is
2799 W Grand Blvd, Detroit, Michigan. You can reach out to his office (for appointments etc.) via phone at
(313) 916-2600.
Carl Joseph Domigan is licensed to practice in Michigan (license number 4704255427) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1528608411.
Physician's Profile
Full Name | Carl Joseph Domigan |
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Gender | Male |
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Speciality | Nurse Practitioner - Neonatal |
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Location | 2799 W Grand Blvd, Detroit, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1528608411
- Provider Enumeration Date: 01/08/2020
- Last Update Date: 11/14/2023
Medicare PECOS Information:
- PECOS PAC ID: 8426488800
- Enrollment ID: I20200427001520
Medical Identifiers
Medical identifiers for Carl Joseph Domigan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1528608411 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 4704255427 (Michigan) | Secondary |
363L00000X | Nurse Practitioner | 4704255427 (Michigan) | Secondary |
363LN0000X | Nurse Practitioner - Neonatal | 4704255427 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carl Joseph Domigan allows following entities to bill medicare on his behalf.
Entity Name | Regents Of The University Of Michigan |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1447275102 PECOS PAC ID: 3779496856 Enrollment ID: O20031121000371 |
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Entity Name | Henry Ford Health System |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1104900455 PECOS PAC ID: 0547178311 Enrollment ID: O20031210000341 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carl Joseph Domigan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Carl Joseph Domigan, NNP-BC 2799 W Grand Blvd, Detroit, MI 48202-2608 Ph: (313) 916-2600 | Carl Joseph Domigan, NNP-BC 2799 W Grand Blvd, Detroit, MI 48202-2608 Ph: (313) 916-2600 |
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