Individual provider Active NPI

Isaac Dominguez, PA-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1023480159
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52837 Issued in CA
Practice address
5385 Franklin Blvd Ste K
Sacramento, CA 95820-4717
Phone
(916) 569-8484
Fax
(530) 661-1027
NPI assigned
Oct 28, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 52837 CA Primary

Addresses

Primary practice location

5385 Franklin Blvd Ste K
Sacramento, CA 95820-4717

Mailing address

1860 Howe Ave Ste 440
Sacramento, CA 95825-1098
Phone (916) 569-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160225002001 CA Practitioner - Physician Assistant 3971808155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
52837CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Elica Health Centers CurrentSince May 1, 2025 Accepting new patients
Elica Health Centers CurrentSince May 1, 2025 Accepting new patients

Locations

1860 Howe Ave
Ste 440
Sacramento, CA 95825

1750 Wright St
Ste 1
Sacramento, CA 95825

5385 Franklin Blvd
Ste K
Sacramento, CA 95820
Phone (916) 428-0656

155 15th St
Ste A
West Sacramento, CA 95691
Phone (916) 375-8981

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15691/brand/4/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1023480159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5385 FRANKLIN BLVD STE K",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958204717",
            "telephone_number": "916-569-8484",
            "fax_number": "530-661-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "ISAAC",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-28",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.