Dominique Ely, AGACNP-BC
NPI 1629490081ActiveIndividual· Nurse Practitioner, Acute Care· Decatur, IL
Nurse Practitioner, Acute Care (AGACNP-BC) in Decatur, Illinois, trained at University of Illinois College of Med (Chi/Peor/Rock/Chm-Urb) (class of 2013). 32 Medicare patients in 2024, $3,823 paid; all of their 50 Part D prescriptions were generic. Organogenesis Inc. reported $22.72 in payments in 2025, mostly food and beverage.
Overview
| NPI | 1629490081 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | AGACNP-BC |
| Sole proprietor | No |
| NPI issued | Jan 20, 2014 |
| Last updated in NPPES | Sep 24, 2024 |
| Certified by provider | Sep 24, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Acute Care Primary | 363LA2100X | 209011112 | IL |
| Nurse Practitioner | 363L00000X | 209011112 | IL |
| Nurse Practitioner, Adult Health | 363LA2200X | 209011112 | IL |
| Nurse Practitioner, Gerontology | 363LG0600X | 209011112 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 32 |
|---|---|
| Services billed | 44 across 21 procedure codes |
| Paid by Medicare | $3,823 |
Part D prescriptions in 2024
| Prescriptions (claims) | 50 · 82 30-day fills |
|---|---|
| Patients | 26 |
| Total drug cost | $265.09 |
| Generic share | 100% of claims |
Education and affiliations
| Medical school | University of Illinois College of Med (Chi/Peor/Rock/Chm-Urb) |
|---|---|
| Graduation year | 2013 |
| Medicare specialty | Nurse Practitioner |
Medical group
- Siu Physicians and Surgeons IncSpringfield, IL · 314 clinicians
Hospital affiliation
- Decatur Memorial HospitalDecatur, IL
Industry payments (Open Payments)
- 2025$22.72 · 1 payment from 1 company
- 2024$56.60 · 2 payments from 2 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Organogenesis Inc. | $22.72 | 1 |
What the 2025 payments were for
- Food and Beverage$22.72 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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