Diana Santo Domingo, MD in Santa Rosa, CA

Diana Santo Domingo, MD is a medicare enrolled "Dermatology" physician in Santa Rosa, California. Her current practice location is 3883 Airway Dr Ste 203, Santa Rosa, California. You can reach out to her office (for appointments etc.) via phone at (707) 521-4495.

Diana Santo Domingo is licensed to practice in California (license number C168169) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1437350709.

Contact Information

	Diana Santo Domingo, MD
	3883 Airway Dr Ste 203, Santa Rosa, CA 95403-1671
	(707) 521-4495
	(707) 573-5421

Map and Direction

Physician's Profile

Full Name	Diana Santo Domingo
Gender	Female
Speciality	Dermatology
Location	3883 Airway Dr Ste 203, Santa Rosa, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1437350709
Provider Enumeration Date: 05/31/2007
Last Update Date: 09/22/2023

Medicare PECOS Information:

PECOS PAC ID: 8022242247
Enrollment ID: I20200609002644

Medical Identifiers

Medical identifiers for Diana Santo Domingo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1437350709	NPI	-	NPPES
C168169	Other	CA	STATE MEDICAL LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	997612 (California)	Secondary
207N00000X	Dermatology	C168169 (California)	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. Diana Santo Domingo allows following entities to bill medicare on her behalf.

Entity Name	Csi Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871909804 PECOS PAC ID: 5890916845 Enrollment ID: O20141016001930

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. Diana Santo Domingo 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
Diana Santo Domingo, MD 325 Distel Cir, Los Altos, CA 94022-1408 Ph: (707) 521-4495	Diana Santo Domingo, MD 3883 Airway Dr Ste 203, Santa Rosa, CA 95403-1671 Ph: (707) 521-4495

Reviews and Comments

Dermatology Doctors in Santa Rosa, CA

Ligaya Francis Park, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2725 Mendocino Ave, Santa Rosa, CA 95403 Phone: 707-545-4537 Fax: 707-545-6726
Judith Hong, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2725 Mendocino Ave, Santa Rosa, CA 95403 Phone: 707-545-4537 Fax: 707-545-6726
Dr. William Francis Kivett, MD, FAAD, FACS Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1140 Sonoma Ave Ste 1a, Santa Rosa, CA 95405 Phone: 707-275-6410
Dr. Stephen D. Schwartz, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4727a Hoen Ave, Santa Rosa, CA 95405 Phone: 707-527-0342 Fax: 707-527-0818
Dr. Henry Eric Degroot, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 196 Wikiup Dr, Santa Rosa, CA 95403 Phone: 707-527-9517 Fax: 707-527-9913
Dr. Robert An-kuo Lee, MD, PHD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3883 Airway Dr Ste 203, Santa Rosa, CA 95403 Phone: 707-521-7760 Fax: 707-521-7759
Dr. Julie Christine Plante, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 6574 Oakmont Dr, Ste B, Santa Rosa, CA 95409 Phone: 707-542-5664 Fax: 707-542-6887

Diana Santo Domingo, MD - Medicare Dermatology in Santa Rosa, CA