THERESA M DOMAGOLA (ACNP-BC, PMHNP-BC) – Acute Care Nurse Practitioner, NPI 1184676322
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for THERESA M DOMAGOLA (ACNP-BC, PMHNP-BC)
15255 MAX LEGGETT PKWY STE 3600
JACKSONVILLE, FL 322187279
Phone: (904) 427-6895
Type: Mailing
South Clinton Avenue, Washington Square, Rochester, Monroe, New York, 14647, United States
SUITE 100
ROCHESTER, NY 146182663
Phone: (585) 442-5320
Fax: (585) 442-5526
Type: Mailing
101, Canal Landing Boulevard, City of Rochester, Monroe County, New York, 14626, United States
SUITE 8
ROCHESTER, NY 146265109
Phone: (585) 239-7300
Fax: (585) 227-7723
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: 2019-12-27
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 |
|---|---|---|---|---|
| I20050617000289 | I | Nurse Practitioner | NY | TBD |
| I20191227001192 | I | Nurse Practitioner | FL | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 133 | 96 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 71 | 41 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 20 | 20 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 32218)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | MT | |
| Clinical Psychologist | LA | |
| Clinical Social Worker | FL | |
| Nurse Practitioner | FL | |
| Clinical Social Worker | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Certified Nurse Midwife (Cnm) | FL | |
| Clinical Social Worker | MN |
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