Dominique Ely, AGACNP-BC - Medicare Nurse Practitioner in Decatur, IL

Dominique Ely, AGACNP-BC is a medicare enrolled "Nurse Practitioner - Acute Care" in Decatur, Illinois. She went to University Of Illinois College Of Med (chi/peor/rock/chm-urb) and graduated in 2013 and has 11 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Siu Physicians And Surgeons Inc and her current practice location is 302 W Hay St Ste 140, Decatur, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 872-2713.

Dominique Ely is licensed to practice in Illinois (license number 209011112) 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 1629490081.

Contact Information

Dominique Ely, AGACNP-BC
302 W Hay St Ste 140,
Decatur, IL 62526-4168
(217) 872-2713
(217) 545-1958

Map and Direction




Provider's Profile

Full NameDominique Ely
GenderFemale
SpecialityNurse Practitioner
Experience11 Years
Location302 W Hay St Ste 140, Decatur, Illinois
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dominique Ely attended and graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 2013
  NPI Data:
  • NPI Number: 1629490081
  • Provider Enumeration Date: 01/20/2014
  • Last Update Date: 09/24/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 6002046935
  • Enrollment ID: I20140220000660

Medical Identifiers

Medical identifiers for Dominique Ely such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629490081NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 209011112 (Illinois)Secondary
363LA2200XNurse Practitioner - Adult Health 209011112 (Illinois)Secondary
363LG0600XNurse Practitioner - Gerontology 209011112 (Illinois)Secondary
363LA2100XNurse Practitioner - Acute Care 209011112 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Decatur Memorial HospitalDecatur, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Siu Physicians And Surgeons Inc2365352820282

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. Dominique Ely allows following entities to bill medicare on her behalf.
Entity NameSiu Physicians & Surgeons Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558385989
PECOS PAC ID: 2365352820
Enrollment ID: O20031222000769
Entity NameCarle Health Care Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154653947
PECOS PAC ID: 3577515774
Enrollment ID: O20100513000829

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. Dominique Ely 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 AddressPractice Location Address
Dominique Ely, AGACNP-BC
Po Box 19639,
Springfield, IL 62794-9639

Ph: (217) 545-8000
Dominique Ely, AGACNP-BC
302 W Hay St Ste 140,
Decatur, IL 62526-4168

Ph: (217) 872-2713

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.