Individual provider Active NPI

Sonya Jean Dominguez, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1063468247
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME95388 Issued in FL
Practice address
2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone
(904) 308-7372
Fax
(904) 308-2998
NPI assigned
May 26, 2006
Last updated
Nov 19, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME95388 FL Primary

Addresses

Primary practice location

2627 Riverside Ave
Jacksonville, FL 32204-4712

Mailing address

2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone (904) 308-7372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20061208000412 FL Practitioner - Family Practice 1052310661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Warren Alpert Medical School of Brown University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincents Medical Center IncGroup PAC ID 0244144558, 17 clinicians

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone (904) 308-7372

2627 Riverside Ave
Jacksonville, FL 32204-4717

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Medical Center Inc CurrentSince Jul 1, 2006 Accepting new patients
St Vincents Medical Center Inc CurrentSince Jul 1, 2006 Accepting new patients

Locations

2627 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7372

Interoperability endpoints

  • Direct secure messaging: sonya.dominguez.1@8967.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1063468247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-308-7372",
            "fax_number": "904-308-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-308-7372",
            "fax_number": "904-308-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "SONYA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME95388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.