Kenneth William Domuczicz Jr., MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

L6865 Issued in TX

Practice address

1201 W 38TH St
#101
Austin, TX 78705-1006

Phone

(512) 324-1010

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

Yes

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 TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12515/brand/6/csg/1/fhir/r4

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.

• Cec Lakeway Urgent Care Physicians PLLC

  • Urgent Care Clinic/Center
  • Lakeway, TX
  • NPI 1285088161
  Medicare reassignment NPD
• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment NPD
• Brazos Valley Emergency Physicians PA

  • Emergency Medicine Physician
  • Navasota, TX
  • NPI 1982642955
  NPD (past)
• Bryan Emergency Physicians PA

  • Emergency Medicine Physician
  • Bryan, TX
  • NPI 1417995481
  NPD (past)
• Complete Emergency Care la Vernia LLC

  • Emergency Care Clinic/Center
  • La Vernia, TX
  • NPI 1568835569
  NPD (past)
• La Vernia Erl Acquisition Partners LLC

  • Emergency Care Clinic/Center
  • La Vernia, TX
  • NPI 1225825946
  NPD (past)
• Lakeway Era Acquistion Partners LLC

  • Emergency Care Clinic/Center
  • Lakeway, TX
  • NPI 1093165631
  NPD (past)
• Westlake Complete Care LLC

  • Emergency Care Clinic/Center
  • Austin, TX
  • NPI 1497115539
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1043275258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 FAWN RUN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787356404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W 38TH ST",
            "address_2": "#101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051006",
            "telephone_number": "512-324-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMUCZICZ",
        "first_name": "KENNETH",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L6865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marco Antonio Vasquez Dominguez
• Mikaela Dominguez
• Dominic Ansari Pediatrics, PLLC
• Dominion Medical Associates PA
• Samantha Domino
• Heather D Donaghey, CPNP
• John Donahoe, M.D.
• Caden Christopher Donahue
• Crysti Donahue, APRN-CNM
• Shannon Williams Donahue, MA, CCC-SLP

• Emergency Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.