Individual provider Active NPI

Jesus David Dominguez, M.D.

  • Anesthesiology Physician
  • Lebanon, NH
National Provider Identifier
1023495678
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
38038 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-0001
Phone
(603) 650-5000
NPI assigned
May 4, 2015
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 312113 LA
Anesthesiology Physician 207L00000X 042-0015635 VT
Anesthesiology Physician 207L00000X 38038 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-0001

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (866) 624-7637

Other practice location 1

1514 Jefferson Hwy
Dept of Anesthesiology
New Orleans, LA 70121-2429
Phone (866) 624-7637

Other practice location 2

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, VA, DC, NH4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20220412002330 VT Practitioner - Anesthesiology 6507164308 Reassigns benefits to 1 organization
I20240520003960 VA Practitioner - Anesthesiology 6507164308 Reassigns benefits to 1 organization
I20240529000780 DC Practitioner - Anesthesiology 6507164308 Reassigns benefits to 1 organization
I20250821003179 NH Practitioner - Anesthesiology 6507164308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0015635VTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 13, 2025 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 13, 2025 Accepting new patients
Northstar Anesthesia of Virginia, LLC Anesthesiology CurrentSince Dec 4, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic Anesthesiology CurrentSince Aug 13, 2025 Accepting new patients
University of Vermont Medical Center Inc Anesthesiology CurrentSince Mar 1, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 13, 2025 Accepting new patients

Locations

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700

130 Fisher Rd
Berlin, VT 05602
Phone (802) 225-5820

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

Organizations & group practices 6

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1023495678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "866-624-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Jefferson Hwy",
            "address_2": "Dept of Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701212429",
            "country_code": "US",
            "telephone_number": "866-624-7637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JESUS",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "312113",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VT",
            "license": "042-0015635",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NH",
            "license": "38038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.