DR. DOMINIC T. SR. HAYNESWORTH (M.D.) – Emergency Medicine Physician, NPI 1073550752
Emergency Medicine Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. DOMINIC T. SR. HAYNESWORTH (M.D.)
13951 Terrace Rd
East Cleveland, OH 441124308
Phone: (216) 761-3300
Type: Location
2351 E 22ND ST
CLEVELAND, OH 441153111
Phone: (216) 861-6200
Type: Location
3620, Langton Road, Quilliams Highlands, Bluestone, Cleveland Heights, Cuyahoga County, Ohio, 44121, United States
CLEVELAND, OH 441211323
Phone:
Type: Mailing
13951, Terrace Road, Forest Hill Historic District, East Cleveland, Cuyahoga County, Ohio, 44112, United States
EAST CLEVELAND, OH 441124308
Phone: (216) 761-3300
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $77.
Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.
Last reported payment date: 2024-08-24 • Largest payer in this snapshot: Galderma Laboratories, L.P. ($77).
Total Amount
$77
General + Research + Ownership
Payments
1
Total payment records
General Amount
$77
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Galderma Laboratories, L.P. | $77 |
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: 2006-07-12
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20060712000353 | I | Emergency Medicine | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 44112)
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