Dr Evillo M Domingo, MD is a medicare enrolled "Family Medicine" physician in Plymouth, Ohio. He graduated from medical school in 1981 and has 43 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Zigma Visiting Physician Llc and his current practice location is
25 Spring St, Plymouth, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 687-5781.
Dr Evillo M Domingo is licensed to practice in Ohio (license number 35-07-4369-D) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1770587693.
Physician's Profile
| Full Name | Dr Evillo M Domingo |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 43 Years |
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| Location | 25 Spring St, Plymouth, Ohio |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Evillo M Domingo graduated from medical school in 1981
NPI Data:
- NPI Number: 1770587693
- Provider Enumeration Date: 06/09/2005
- Last Update Date: 08/14/2018
Medicare PECOS Information:
- PECOS PAC ID: 7719962737
- Enrollment ID: I20160310000772
Medical Identifiers
Medical identifiers for Dr Evillo M Domingo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770587693 | NPI | - | NPPES |
| 2083972 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 35-07-4369-D (Ohio) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Zigma Visiting Physician Llc | 0547566994 | 3 |
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. Dr Evillo M Domingo allows following entities to bill medicare on his behalf.
| Entity Name | Zigma Visiting Physician Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093175804
PECOS PAC ID: 0547566994
Enrollment ID: O20160310000631 |
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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. Dr Evillo M 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 |
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Dr Evillo M Domingo, MD
2750 Neal Zick Rd,
Willard, OH 44890-9282
Ph: (567) 224-0854 | Dr Evillo M Domingo, MD
25 Spring St,
Plymouth, OH 44865
Ph: (419) 687-5781 |
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