Dominique Jean Loguidice, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00631600 Issued in NJ

Practice address

113 W Essex St Ste 204
Maywood, NJ 07607-1023

Phone

(201) 289-5551

NPI assigned

Aug 4, 2021

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

Medicare fee-for-service enrollment

Enrolled in NJ

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

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Plastic Surgery CenterGroup PAC ID 8921060484, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: dloguidice536007@direct.ahsys.org

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.

• The Plastic Surgery Center

  dba The Plastic Surgery Center, PA

  • Plastic and Reconstructive Surgery Physician
  • Red Bank, NJ
  • NPI 1386613834
  Medicare reassignment Care Compare group
• The Woods O.R., Inc.

  dba The Center For Outpatient Surgery

  • Ambulatory Surgical Clinic/Center
  • Tinton Falls, NJ
  • NPI 1952610768
  NPD (past)

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

• HMH Hospitals Corporation

  dba Hackensack University Medical Center

  • General Acute Care Hospital
  • Hackensack, NJ
  • NPI 1457456279
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Hackensack, NJ
  • NPI 1518683929

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1063186963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W ESSEX ST STE 204",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071023",
            "telephone_number": "201-289-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W ESSEX ST STE 204",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071023",
            "telephone_number": "201-289-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGUIDICE",
        "first_name": "DOMINIQUE",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00631600",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00631600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Lewycky, DMD
• Lighthouse Anesthesia Partners LLC
• Stephen R Lindholm, MD
• Phoebe Livanis
• Dara Lobuono, MS RD
• Lorelei Orthotics & Prosthetics, Inc.
• Gregory G Lovallo, M.D.
• Geok Low
• Victoria-Len Lumapan
• Cheryl Lupica, MA SLP-CCC

• Surgical Physician Assistant in Maywood, NJ
• Providers in Maywood, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.