Mark Jason Dominguez, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

200251 Issued in LA

Practice address

606 W 11TH Ave
Covington, LA 70433-3630

Phone

(985) 892-3766

Fax

(985) 893-9567

NPI assigned

May 21, 2007

Sex

Male

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 LA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.dominguez.1@5868.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/5868/brand/1/csg/1/fhir/r4
• Direct secure messaging: mark.dominguez.1@19794.direct.athenahealth.com
• Direct secure messaging: mark.dominguez.1@17837.direct.athenahealth.com

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.

• Allegiance Hospital of Many, LLC

  • General Acute Care Hospital
  • Many, LA
  • NPI 1568626273

  LA

  Medicare reassignment Care Compare group NPD
• Byrd Medical Clinic Inc

  • Family Medicine Physician
  • Leesville, LA
  • NPI 1801895495

  LA, Surgery

  Medicare reassignment Care Compare group NPD
• Glen D. Hurlston, M.D., Apmc

  • Anesthesiology Physician
  • Leesville, LA
  • NPI 1306913488

  LA

  Medicare reassignment Care Compare group NPD
• Hodges Emergency Group, LLC

  • Emergency Medicine Physician
  • Many, LA
  • NPI 1710441316

  LA

  Medicare reassignment Care Compare group NPD
• Kisatchie Emergency Group, LLC

  • Emergency Medicine Physician
  • Leesville, LA
  • NPI 1235693847

  LA

  Medicare reassignment Care Compare group NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610

  LA

  Medicare reassignment Care Compare group NPD
• Emergency Group of St Landry LLC

  • Emergency Medicine Physician
  • Ville Platte, LA
  • NPI 1164491320

  LA

  Medicare reassignment NPD
• Lallie Kemp Medical Ctr

  • Critical Access Hospital
  • Independence, LA
  • NPI 1558303420

  LA

  Medicare reassignment NPD
• Mercy Physician Practices LLC

  • Family Medicine Physician
  • Ville Platte, LA
  • NPI 1598885832

  LA

  Medicare reassignment NPD
• Restore Mobile Wound Care

  • Surgery Physician
  • Metairie, LA
  • NPI 1528808268

  LA, Surgery

  Medicare reassignment NPD
• Allegiance Hospital of Many, LLC

  • Rural Health Clinic/Center
  • Many, LA
  • NPI 1275010712
  Care Compare group NPD (past)
• Real Results Clinic LLC

  • Surgery Physician
  • Covington, LA
  • NPI 1770834145

  Surgery

  NPD (past) Authorized official

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

• Allegiance Hospital of Many, LLC

  • Psychiatric Hospital Unit
  • Zwolle, LA
  • NPI 1497219257

  Hospital

  Care Compare affiliation
• Allegiance Hospital of Many, LLC

  • General Acute Care Hospital
  • Many, LA
  • NPI 1568626273

  Hospital

  Care Compare affiliation
• CLHG-Leesville

  • General Acute Care Hospital
  • Leesville, LA
  • NPI 1881665164

  Hospital

  Care Compare affiliation
• Hospital Service District No 2 of Parish of Beauregard State of la

  • Rural Acute Care Hospital
  • Deridder, LA
  • NPI 1831193499

  Hospital

  Care Compare affiliation

Specialty

General Surgery

Education

Louisiana State University School of Medicine in New Orleans, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Byrd Medical Clinic Inc 10 clinicians

Glen D. Hurlston, M.D., Apmc 26 clinicians

Kisatchie Emergency Group LLC 19 clinicians

Allegiance Hospital of Many, LLC 40 clinicians

Hodges Emergency Group LLC 19 clinicians

Concord Medical Group PLLC 189 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Byrd Regional Hospital Hospital, Leesville, LA, CCN 190164
• Sabine Medical Center Hospital, Many, LA, CCN 190218
• Beauregard Memorial Hospital Hospital, Deridder, LA, CCN 190050

Procedures performed for Medicare patients

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1043428170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54482",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701544482",
            "telephone_number": "985-898-3740",
            "fax_number": "985-898-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 W 11TH AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704333630",
            "telephone_number": "985-892-3766",
            "fax_number": "985-893-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MARK",
        "middle_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "200251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doctors for Women Medical Center
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• Leslie Copeland Dominguez, M.D.
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• Donna L. Hunstock Inc.
• Rachel Donovan
• Janet H Dornier, APRN FNP-C

• All providers in Covington, LA
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.