Arely Dominguez Gonzalez, FNP in Fountain, CO

Arely Dominguez Gonzalez, FNP is a medicare enrolled "Nurse Practitioner - Family" in Fountain, Colorado. Her current practice location is 350 Lyckman Pl, Fountain, Colorado. You can reach out to her office (for appointments etc.) via phone at (719) 632-5700.

Arely Dominguez Gonzalez is licensed to practice in Colorado (license number C-APN.0003054-C-NP) 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 1548826670.

Contact Information

	Arely Dominguez Gonzalez, FNP
	350 Lyckman Pl, Fountain, CO 80817-2861
	(719) 632-5700
	(719) 322-0776

Map and Direction

Provider's Profile

Full Name	Arely Dominguez Gonzalez
Gender	Female
Speciality	Nurse Practitioner - Family
Location	350 Lyckman Pl, Fountain, Colorado
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1548826670
Provider Enumeration Date: 05/14/2019
Last Update Date: 08/25/2021

Medicare PECOS Information:

PECOS PAC ID: 1355675703
Enrollment ID: I20210901001528

Medical Identifiers

Medical identifiers for Arely Dominguez Gonzalez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548826670	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	5011630 (North Carolina)	Secondary
363LF0000X	Nurse Practitioner - Family	C-APN.0003054-C-NP (Colorado)	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. Arely Dominguez Gonzalez allows following entities to bill medicare on her behalf.

Entity Name	Peak Vista Community Health Centers
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730166034 PECOS PAC ID: 4688583974 Enrollment ID: O20031110000337

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. Arely Dominguez Gonzalez 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
Arely Dominguez Gonzalez, FNP Po Box 669, Ahoskie, NC 27910-0669 Ph: (252) 209-0237	Arely Dominguez Gonzalez, FNP 350 Lyckman Pl, Fountain, CO 80817-2861 Ph: (719) 632-5700

Reviews and Comments

Nurse Practitioner Nurses in Fountain, CO

Mrs. Malory Kay Splawn, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 350 Lyckman Pl, Fountain, CO 80817 Phone: 719-632-5700
Andrea Verlare, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6908 Mesa Ridge Pkwy, Fountain, CO 80817 Phone: 719-471-2273 Fax: 719-380-0228
Jennifer Keys, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6908 Mesa Ridge Pkwy, Fountain, CO 80817 Phone: 719-471-2273 Fax: 719-380-0228
Leslie Michelle Mudge, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6908 Mesa Ridge Pkwy, Fountain, CO 80817 Phone: 719-505-3822 Fax: 719-380-0228
Agnes Mauryn Jepkogei Kiptum, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6908 Mesa Ridge Pkwy, Fountain, CO 80817 Phone: 719-471-2273
Heath Christianson, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6908 Mesa Ridge Pkwy, Fountain, CO 80817 Phone: 719-471-2273

Arely Dominguez Gonzalez, FNP - Medicare Nurse Practitioner in Fountain, CO