Lorena Dominguez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

236 Broadway
Brooklyn, NY 11211-6289

Phone

(718) 804-5939

NPI assigned

Nov 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• BP Immediate Medical Care, PC

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1205105004
  Medicare reassignment
• Pharma Holding Inc

  • Pharmacy
  • Brooklyn, NY
  • NPI 1396153680
  NPD (past)
• Rockland Medical Group, PLLC

  • Internal Medicine Physician
  • Garnerville, NY
  • NPI 1336172501
  NPD (past)

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1023612397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CEDARLAWN BLVD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112116289",
            "telephone_number": "718-804-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "LORENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Dominguez
• Gabriella Dominguez
• Helaine Dominguez, RN
• Jennifer Dominguez
• Kelwin Jairo Dominguez
• Luirca Dominguez
• Micaiah Dominguez
• Nicole Brenes Dominguez, PHARM D.
• Dominic J Rubino, DC, PC
• Eileen Dominick

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.