Mrs Dominique Gisele Guillaume, MSN, AGPCNP-BC in Bowie, MD

Mrs Dominique Gisele Guillaume, MSN, AGPCNP-BC is a medicare enrolled "Nurse Practitioner - Adult Health" in Bowie, Maryland. Her current practice location is 4000 Mitchellville Rd Ste A406, Bowie, Maryland. You can reach out to her office (for appointments etc.) via phone at (301) 262-0400.

Mrs Dominique Gisele Guillaume is licensed to practice in Maryland (license number R215205) 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 1780318014.

Contact Information

	Mrs Dominique Gisele Guillaume, MSN, AGPCNP-BC
	4000 Mitchellville Rd Ste A406, Bowie, MD 20716-3139
	(301) 262-0400
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Dominique Gisele Guillaume
Gender	Female
Speciality	Nurse Practitioner - Adult Health
Location	4000 Mitchellville Rd Ste A406, Bowie, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780318014
Provider Enumeration Date: 07/12/2022
Last Update Date: 01/04/2023

Medicare PECOS Information:

PECOS PAC ID: 5193193134
Enrollment ID: I20221122002109

Medical Identifiers

Medical identifiers for Mrs Dominique Gisele Guillaume such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780318014	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	R215205 (Maryland)	Primary
363LA2200X	Nurse Practitioner - Adult Health	RN256248 (Georgia)	Secondary

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. Mrs Dominique Gisele Guillaume allows following entities to bill medicare on her behalf.

Entity Name	Daydream Sunshine Initiative
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205435328 PECOS PAC ID: 9638562523 Enrollment ID: O20220217002191

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. Mrs Dominique Gisele Guillaume 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
Mrs Dominique Gisele Guillaume, MSN, AGPCNP-BC 31 N Streeper St, Baltimore, MD 21224-1250 Ph: (770) 561-7965	Mrs Dominique Gisele Guillaume, MSN, AGPCNP-BC 4000 Mitchellville Rd Ste A406, Bowie, MD 20716-3139 Ph: (301) 262-0400

Reviews and Comments

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Mrs Dominique Gisele Guillaume, MSN, AGPCNP-BC - Medicare Nurse Practitioner in Bowie, MD