ELIDES DOMINGUEZ (CACII) – General Practice Physician, NPI 1124475835

ELIDES DOMINGUEZ (CACII) is a healthcare provider. based in Wesley chapel, Florida. specializing in GENERAL PRACTICE. They hold the professional credentials CACII. They hold a License No. ACN1111 (FL). The NPI Number for ELIDES DOMINGUEZ (CACII) is 1124475835

Main info

Female
43 Years Of Experience
Accepts Medicare Assignment
Name
ELIDES DOMINGUEZ (CACII)
NPI
1124475835
Phone
(813) 907-6767
Address
2607 WINDGUARD CIR STE 102
Enumeration Date
23 May 2016
Last Update Date
11 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5614324577
Graduation Year
1983 (43 years ago)
PAC ID
4880934785
Group Practice PAC ID
0446679468
Professional Enrollment ID
I20190312002293
Address ID
FL334612142PA1670XAVEX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,466 GENERAL PRACTICE in FL

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Provider Addresses for ELIDES DOMINGUEZ (CACII)

  • Windguard Circle, Wesley Chapel, Pasco County, Florida, 33544, United States

    WESLEY CHAPEL, FL 335447352

    Phone: (813) 907-6767

    Fax: (813) 907-1911

    Type: Mailing

  • 5626 CURRY FORD RD

    ORLANDO, FL 328221424

    Phone: (407) 985-5677

    Fax: (844) 388-6186

    Type: Mailing

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: 2019-03-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190312002293IGeneral PracticeFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33544)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446679468View full group profile
NameSpecialtyState
Family PracticeFL
Family PracticeFL
Family PracticeFL
Internal MedicineFL
Internal MedicineFL
Nurse PractitionerFL
General Practice, Family PracticeFL
General PracticeFL
Internal MedicineFL
Internal MedicineFL

Reviews

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Frequently asked questions

How do payers reference ELIDES DOMINGUEZ (CACII)?
For ELIDES DOMINGUEZ (CACII), use NPI 1124475835 as the unique 10-digit identifier.
Is ELIDES DOMINGUEZ (CACII) shown as active in public data?
Registry records indicate ELIDES DOMINGUEZ (CACII) maintains an active NPI.
What area of care is associated with ELIDES DOMINGUEZ (CACII)?
ELIDES DOMINGUEZ (CACII)'s record emphasizes General Practice Physician. Clinical services aligned with this taxonomy classification.
Where in Florida is ELIDES DOMINGUEZ (CACII) registered?
Use Wesley Chapel, Florida as the headline location for ELIDES DOMINGUEZ (CACII) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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