Mr Samuel Domingo, MSN, FNP in Laguna Hills, CA

Mr Samuel Domingo, MSN, FNP is a medicare enrolled "Nurse Practitioner - Family" in Laguna Hills, California. His current practice location is 24012 Calle De La Plata Ste 120, Laguna Hills, California. You can reach out to his office (for appointments etc.) via phone at (949) 588-7246.

Mr Samuel Domingo is licensed to practice in California (license number 95029993) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063254910.

Contact Information

	Mr Samuel Domingo, MSN, FNP
	24012 Calle De La Plata Ste 120, Laguna Hills, CA 92653-3632
	(949) 588-7246
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Samuel Domingo
Gender	Male
Speciality	Nurse Practitioner - Family
Location	24012 Calle De La Plata Ste 120, Laguna Hills, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063254910
Provider Enumeration Date: 06/11/2024
Last Update Date: 03/13/2026

Medicare PECOS Information:

PECOS PAC ID: 3779028899
Enrollment ID: I20240712003857

Medical Identifiers

Medical identifiers for Mr Samuel Domingo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063254910	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95029993 (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. Mr Samuel Domingo allows following entities to bill medicare on his behalf.

Entity Name	Spine & Nerve Diagnostic Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144628504 PECOS PAC ID: 9830416460 Enrollment ID: O20150319001739

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. Mr Samuel 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
Mr Samuel Domingo, MSN, FNP 2119 Pendio, Irvine, CA 92620-1760 Ph: (562) 540-6633	Mr Samuel Domingo, MSN, FNP 24012 Calle De La Plata Ste 120, Laguna Hills, CA 92653-3632 Ph: (949) 588-7246

Reviews and Comments

Nurse Practitioner Nurses in Laguna Hills, CA

Wenli Li, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 25431 Cabot Rd Ste 118, Laguna Hills, CA 92653 Phone: 949-362-8877
Miss Corazon Escusa Francisco, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 23181 Verdugo Dr Ste 103a, Laguna Hills, CA 92653 Phone: 949-366-1053
Mrs. Christine Jeaneun Kim, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 23141 Moulton Pkwy Ste 213, Laguna Hills, CA 92653 Phone: 949-258-3741 Fax: 949-258-3742
Michelle Rhyner, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 23183 La Cadena Dr Ste 103, Laguna Hills, CA 92653 Phone: 714-838-8188
Tiffany Ann Cervenak, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 24012 Calle De La Plata, Suite 150, Laguna Hills, CA 92653 Phone: 949-837-1578 Fax: 949-837-8154
Maryam Fathy, DNP, MSN, RN, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 24451 Health Center Dr, Laguna Hills, CA 92653 Phone: 949-424-9730 Fax: 949-452-7599

Mr Samuel Domingo, MSN, FNP - Medicare Nurse Practitioner in Laguna Hills, CA