Carlo Domingo, AGNP-C is a medicare enrolled "Nurse Practitioner - Gerontology" in Hainesville, Illinois. He went to Johns Hopkins University School Of Medicine and graduated in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Zigma Visiting Physician Llc and his current practice location is
4 N Deer Point Dr, Ste 1002, Hainesville, Illinois. You can reach out to his office (for appointments etc.) via phone at
(847) 946-0198.
Carlo Domingo is licensed to practice in Illinois (license number 209.019378) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1194251272.
Provider's Profile
| Full Name | Carlo Domingo |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 9 Years |
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| Location | 4 N Deer Point Dr, Hainesville, Illinois |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Carlo Domingo attended and graduated from Johns Hopkins University School Of Medicine in 2015
NPI Data:
- NPI Number: 1194251272
- Provider Enumeration Date: 05/10/2017
- Last Update Date: 10/11/2021
Medicare PECOS Information:
- PECOS PAC ID: 9537595830
- Enrollment ID: I20200205000961
Medical Identifiers
Medical identifiers for Carlo Domingo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1194251272 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2200X | Nurse Practitioner - Adult Health | 209.019378 (Illinois) | Secondary |
| 363LG0600X | Nurse Practitioner - Gerontology | 209.019378 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Zigma Visiting Physician Llc | 0547566994 | 4 |
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. Carlo Domingo allows following entities to bill medicare on his behalf.
| Entity Name | Zigma Visiting Physician Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093175804
PECOS PAC ID: 0547566994
Enrollment ID: O20160310000631 |
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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. Carlo 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 |
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Carlo Domingo, AGNP-C
4 N Deer Point Dr., Ste 1002,
Hainesville, IL 60030-3814
Ph: (847) 946-0198 | Carlo Domingo, AGNP-C
4 N Deer Point Dr, Ste 1002,
Hainesville, IL 60030-3814
Ph: (847) 946-0198 |
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