Jaena Michelle Dominguez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5849 Issued in SC

Practice address

1613 Oakwood St
Bedford, VA 24523-1213

Phone

(843) 494-8441

NPI assigned

Jun 28, 2022

Last updated

Jun 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Physician Assistant

Education

University of South Carolina School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.16 of 100Reported as apm

Quality

83.58

Promoting interoperability

94

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Spartanburg Medical Center

  dba Medical Group of the Carolinas-Vascular Access Surgery-Pelham

  • Surgery Physician
  • Greer, SC
  • NPI 1760114664
  Medicare reassignment Care Compare group
• Spartanburg Medical Center

  dba Medical Group of the Carolinas Pain Management Wood Street

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD
• Spartanburg Regional Med Ctr

  dba Surgical Associates of Spartanburg

  • Surgery Physician
  • Spartanburg, SC
  • NPI 1417909037
  NPD
• Spartanburg Medical Center

  dba Medical Group of the Carolinas - Piedmont Women's Healthcare

  • Obstetrics & Gynecology Physician
  • Spartanburg, SC
  • NPI 1376580852
  NPD (past)

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1043942105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 OAKWOOD ST",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245231213",
            "telephone_number": "843-494-8441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1690 Skylyn Dr",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293071022",
            "country_code": "US",
            "telephone_number": "864-577-1600",
            "fax_number": "864-577-1645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JAENA",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5849",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-008657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdominguez287185@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jdominguez287185@direct-srhs.et0939.epichosted.com",
            "address_1": "1690 Skylyn Dr",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293071022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alan M Denekas, M.D.
• Carlee Briann Desimone, COTA
• Kelly P Dinh, PA
• Martin Dittler, CRNA
• Matthew Lee Dixon, PHARMD
• Sheena Renee Dooley
• Mary Allene Doss
• Dr Thomas E Unterbrink OD PC
• Catherine D. Dudley, PT
• Lynn Marshall Dunn, RPH

• Physician Assistant in Bedford, VA
• Providers in Bedford, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.