Samuel Domingo, MSN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95029993 Issued in CA

Practice address

1 Hoag Dr
Newport Beach, CA 92663-4162

Phone

(949) 764-5691

Fax

(949) 764-4242

NPI assigned

Jun 11, 2024

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 CA

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

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.domingo.p45@direct.omnieyeatlanta.nextgenshare.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.

• Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Roseville, CA
  • NPI 1144628504

  CA, Single Specialty

  Medicare reassignment NPD
• Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Folsom, CA
  • NPI 1457902496

  Single Specialty

  NPD
• Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Sacramento, CA
  • NPI 1750789053

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1063254910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 PENDIO",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201760",
            "telephone_number": "562-540-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-5691",
            "fax_number": "949-764-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "MSN, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Bailey Doering, M.D.
• Stephen W Doggett, M.D.
• Michelle Kathryn Dogterom, AMFT
• Victoria Valeri Dolidze, C.P.T.
• Shelley Dolkas Lickl, PA
• Jessica Dominguez
• Steven Dominguez, MD
• Don F. Mills, M.D.
• Donald R. Abrahm M.D., Inc
• Donald S. Mowlds, M.D., a Professional Corporation

• All providers in Newport Beach, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; 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.