Dr Marie A Dominguez, MD is a medicare enrolled "Hospitalist" physician in West Bend, Wisconsin. She went to Uniformed Services Uhs Fe Hebert School Of Med and graduated in 1992 and has 32 years of diverse experience with area of expertise as Hospitalist. She is a member of the group practice The Monroe Clinic Inc, Frances Mahon Deaconess Hospital and her current practice location is
1100 Gateway Ct, West Bend, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(262) 335-8600.
Dr Marie A Dominguez is licensed to practice in Wisconsin (license number 68577) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1952312886.
Physician's Profile
| Full Name | Dr Marie A Dominguez |
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| Gender | Female |
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| Speciality | Hospitalist |
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| Experience | 32 Years |
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| Location | 1100 Gateway Ct, West Bend, Wisconsin |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Marie A Dominguez attended and graduated from Uniformed Services Uhs Fe Hebert School Of Med in 1992
NPI Data:
- NPI Number: 1952312886
- Provider Enumeration Date: 08/09/2006
- Last Update Date: 04/02/2020
Medicare PECOS Information:
- PECOS PAC ID: 5193085256
- Enrollment ID: I20180209000826
Medical Identifiers
Medical identifiers for Dr Marie A Dominguez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1952312886 | NPI | - | NPPES |
| 100074618 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 68577 (Wisconsin) | Secondary |
| 208M00000X | Hospitalist | 68577 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| The Monroe Clinic Inc | 3072425495 | 155 |
| Frances Mahon Deaconess Hospital | 3173430949 | 37 |
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 Marie A Dominguez allows following entities to bill medicare on her behalf.
| Entity Name | The Monroe Clinic Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1386720548
PECOS PAC ID: 3072425495
Enrollment ID: O20031104000392 |
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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 Marie A 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 |
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Dr Marie A Dominguez, MD
1100 Gateway Ct,
West Bend, WI 53095-8539
Ph: (262) 335-8600 | Dr Marie A Dominguez, MD
1100 Gateway Ct,
West Bend, WI 53095-8539
Ph: (262) 335-8600 |
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