Dr Kathleen Marie Dominguez, MD - Medicare Surgery in Urbana, IL

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Dr Kathleen Marie Dominguez, MD is a medicare enrolled "Surgery - Pediatric Surgery" physician in Urbana, Illinois. Her current practice location is 611 W Park St, Urbana, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 383-3100.

Dr Kathleen Marie Dominguez is licensed to practice in Illinois (license number 036146280) 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 1285764886.

Contact Information

Dr Kathleen Marie Dominguez, MD
611 W Park St,
Urbana, IL 61801-2529
(217) 383-3100
(217) 383-4468

Map and Direction




Physician's Profile

Full NameDr Kathleen Marie Dominguez
GenderFemale
SpecialitySurgery - Pediatric Surgery
Location611 W Park St, Urbana, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1285764886
  • Provider Enumeration Date: 03/06/2007
  • Last Update Date: 07/30/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 5496904658
  • Enrollment ID: I20180906001308

Medical Identifiers

Medical identifiers for Dr Kathleen Marie Dominguez such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1285764886NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2086S0120XSurgery - Pediatric Surgery 57264 (Wisconsin)Secondary
2086S0120XSurgery - Pediatric Surgery 036146280 (Illinois)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. Dr Kathleen Marie Dominguez allows following entities to bill medicare on her behalf.
Entity NameHoopeston Community Memorial Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043683014
PECOS PAC ID: 3577456037
Enrollment ID: O20040210000011
Entity NameCarle Health Care Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154653947
PECOS PAC ID: 3577515774
Enrollment ID: O20100513000829

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 Kathleen Marie Dominguez 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 AddressPractice Location Address
Dr Kathleen Marie Dominguez, MD
611 W Park St,
Urbana, IL 61801-2529

Ph: () -		Dr Kathleen Marie Dominguez, MD
611 W Park St,
Urbana, IL 61801-2529

Ph: (217) 383-3100

Reviews and Comments


Surgery Doctors in Urbana, IL

Mahmoud Elrakhawy, MD
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Practice Location: 611 W Park St, Urbana, IL 61801
Phone: 217-904-7000    
Conlan Joseph Pierce, MD
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Brian Robert Beeman, M.D.
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Phone: 217-904-7000    Fax: 217-904-7748
Yongsoo Kwon,
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Practice Location: 1800 Glenwood Oaks Ct, Urbana, IL 61801
Phone: 217-337-5299    
Anant Singh Amar, MD
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Practice Location: 611 W Park St, Urbana, IL 61801
Phone: 217-383-3311    
Beverly Eri Tomita, MD
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Medicare: Not Enrolled in Medicare
Practice Location: 611 W Park St, Urbana, IL 61801
Phone: 217-383-3311    
Richard B Berlin, MD
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Medicare: Medicare Enrolled
Practice Location: 602 W. University Avenue, General Surgery, Urbana, IL 61801
Phone: 217-383-3240    Fax: 217-383-4597

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.