Liezl Tersol Domingo, M.D.
NPI 1871880849ActiveIndividual· Pediatrics, Pediatric Cardiology· Augusta, GA
Pediatrics, Pediatric Cardiology (M.D.) with University of Utah Pediatric Services, practicing in Augusta, Georgia. Part D covered 16 prescriptions written in 2024.
Overview
| NPI | 1871880849 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | No |
| NPI issued | Jun 28, 2011 |
| Last updated in NPPES | Dec 20, 2021 |
| Certified by provider | Dec 20, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics, Pediatric Cardiology Primary | 2080P0202X | 079825 | GA |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Pediatric Medicine (UT) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 16 · 16 30-day fills |
|---|---|
| Total drug cost | $226,543 |
Education and affiliations
| Graduation year | 2005 |
|---|---|
| Medicare specialty | Pediatric Medicine |
Medical group
- University of Utah Pediatric ServicesSalt Lake City, UT · 140 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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