DR. MICHELE DOMENICK (MD) – Surgery Physician, NPI 1720052400
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
132 GENERAL SURGERY in DE
Provider Addresses for DR. MICHELE DOMENICK (MD)
200 Banning St
Suite 200
Dover, DE 199043485
Phone: (302) 674-0600
Fax: (302) 672-7144
Type: Location
200, Banning Street, Dover, Kent County, Delaware, 19904, United States
SUITE 310
DOVER, DE 199043485
Phone: (302) 674-0600
Fax: (302) 672-7144
Type: Mailing
500 CADMUS LN STE 205
EASTON, MD 216014094
Phone: (410) 822-4553
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-07-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130218000016 | I | General Surgery | DE | TBD |
| I20210726002185 | I | General Surgery | MD | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 252 | 252 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 136 | 116 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 97 | 87 | $0 |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 65 | 65 | $0 |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 62 | 62 | $0 |
Insurance plans in this area (ZIP 19904)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | DE | 45378 | Diagnostic examination of large bowel using an endoscope | 52 | 52 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology, Interventional Radiology | TX | |
| - | MD | |
| - | MD | |
| General Surgery | MD | |
| Family Practice | MD | |
| Nurse Practitioner | MD | |
| - | MD | |
| N E U R O S U R G E R Y | MD | |
| U R O L O G Y | OH | |
| Nurse Practitioner | MD |
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