Domonique Shantel Wilson, PMHNP-BC - Medicare Nurse Practitioner in East Liverpool, OH

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Domonique Shantel Wilson, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in East Liverpool, Ohio. Her current practice location is 15613 Pineview Dr Ste C, East Liverpool, Ohio. You can reach out to her office (for appointments etc.) via phone at (330) 932-1594.

Domonique Shantel Wilson is licensed to practice in Ohio (license number APRNCNP0035421) 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 1124893151.

Contact Information

Domonique Shantel Wilson, PMHNP-BC
15613 Pineview Dr Ste C,
East Liverpool, OH 43920-9096
(330) 932-1594
Not Available

Map and Direction




Provider's Profile

Full NameDomonique Shantel Wilson
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location15613 Pineview Dr Ste C, East Liverpool, Ohio
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124893151
  • Provider Enumeration Date: 11/20/2023
  • Last Update Date: 11/20/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7517304256
  • Enrollment ID: I20240318002102

Medical Identifiers

Medical identifiers for Domonique Shantel Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124893151NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health APRNCNP0035421 (Ohio)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. Domonique Shantel Wilson allows following entities to bill medicare on her behalf.
Entity NameCope Treatment Centers In
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417022682
PECOS PAC ID: 1951404540
Enrollment ID: O20070320000503

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. Domonique Shantel Wilson 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
Domonique Shantel Wilson, PMHNP-BC
1132 Pennsbury Blvd,
Pittsburgh, PA 15205-1610

Ph: (412) 251-6004		Domonique Shantel Wilson, PMHNP-BC
15613 Pineview Dr Ste C,
East Liverpool, OH 43920-9096

Ph: (330) 932-1594

Reviews and Comments


Nurse Practitioner Nurses in East Liverpool, OH

Mr. Matthew A Handley, FNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 425 W 5th St, East Liverpool, OH 43920
Phone: 330-385-7200    
Dr. Tammy L Mccoy, CRNP
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Medicare: Medicare Enrolled
Practice Location: 15655 State Route 170 Ste A, East Liverpool, OH 43920
Phone: 330-386-4303    Fax: 216-229-2630
Isaac M Archibeque, FNP-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 48462 Bell School Rd, East Liverpool, OH 43920
Phone: 724-773-1995    
Mrs. Lisa Oliver, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 15655 State Route 170 Ste A, East Liverpool, OH 43920
Phone: 330-386-4303    Fax: 216-229-2630
Mrs. Breanne Michelle Montero, F.N.P.
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 16494 Saint Clair Ave, East Liverpool, OH 43920
Phone: 330-424-7221    
Jennifer Joseph, APRN.CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 236 W 6th St, East Liverpool, OH 43920
Phone: 330-932-1823    Fax: 330-932-1832

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.