Elides Dominguez, CACII is a medicare enrolled "General Practice" physician in Wesley Chapel, Florida. Her current practice location is
2607 Windguard Cir Ste 102, Wesley Chapel, Florida. You can reach out to her office (for appointments etc.) via phone at
(813) 907-6767.
Elides Dominguez is licensed to practice in Florida (license number ACN1111) 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 1124475835.
Physician's Profile
Full Name | Elides Dominguez |
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Gender | Female |
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Speciality | General Practice |
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Location | 2607 Windguard Cir Ste 102, Wesley Chapel, Florida |
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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: 1124475835
- Provider Enumeration Date: 05/23/2016
- Last Update Date: 08/11/2022
Medicare PECOS Information:
- PECOS PAC ID: 4880934785
- Enrollment ID: I20190312002293
Medical Identifiers
Medical identifiers for Elides Dominguez such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124475835 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | ACN1111 (Florida) | 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. Elides Dominguez allows following entities to bill medicare on her behalf.
Entity Name | Pcc Medical Holdings Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1174167993 PECOS PAC ID: 0446679468 Enrollment ID: O20200924001757 |
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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. Elides 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 Address | Practice Location Address |
Elides Dominguez, CACII 5626 Curry Ford Rd, Orlando, FL 32822-1424 Ph: (407) 985-5677 | Elides Dominguez, CACII 2607 Windguard Cir Ste 102, Wesley Chapel, FL 33544-7352 Ph: (813) 907-6767 |
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