Helen Domitrovich, APRN, DNP, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Ontonagon, Michigan. Her current practice location is
601 S 7th St, Ontonagon, Michigan. You can reach out to her office (for appointments etc.) via phone at
(906) 884-8240.
Helen Domitrovich is licensed to practice in Michigan (license number 4704265334) 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 1205677994.
Provider's Profile
| Full Name | Helen Domitrovich |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 601 S 7th St, Ontonagon, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1205677994
- Provider Enumeration Date: 06/05/2024
- Last Update Date: 10/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 3072050574
- Enrollment ID: I20240801002936
Medical Identifiers
Medical identifiers for Helen Domitrovich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1205677994 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | 4704265334 (Michigan) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 4704265334 (Michigan) | 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. Helen Domitrovich allows following entities to bill medicare on her behalf.
| Entity Name | Aspirus Keweenaw |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205998713
PECOS PAC ID: 8123912011
Enrollment ID: O20040211000763 |
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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. Helen Domitrovich 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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Helen Domitrovich, APRN, DNP, FNP-C
601 S 7th St,
Ontonagon, MI 49953-1448
Ph: () - | Helen Domitrovich, APRN, DNP, FNP-C
601 S 7th St,
Ontonagon, MI 49953-1448
Ph: (906) 884-8240 |
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