DOMENIC BERMUDEZ (PA-C) – Medical Physician Assistant, NPI 1215454194
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
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Provider Addresses for DOMENIC BERMUDEZ (PA-C)
2253, Olympic Street, Olympic Hills, Springfield, Clark County, Ohio, 45503, United States
SPRINGFIELD, OH 45503
Phone:
Type: Mailing
2131, Gateway Drive, Fairborn, Greene County, Ohio, 45324, United States
FAIRBORN, OH 453246357
Phone: (937) 873-9500
Type: Location
7709 HOKE RD
ENGLEWOOD, OH 453159725
Phone: (937) 809-2940
Fax: (937) 809-2941
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $34.
Total Amount is formed as General ($34) + Research ($0) + Ownership ($0) = $34.
Last reported payment date: 2024-04-05 • Largest payer in this snapshot: PFIZER INC. ($34).
Total Amount
$34
General + Research + Ownership
Payments
2
Total payment records
General Amount
$34
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $34 |
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: 2017-10-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171011002703 | I | Physician Assistant | OH | 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 | 17 | 17 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 45503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H O S P I T A L I S T | OH | |
| - | OH | |
| - | PA | |
| - | OH | |
| Physician Assistant | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| - | OH |
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