Dominic T. Haynesworth Sr., M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

46583 Issued in OH

Practice address

2351 E 22ND St
Cleveland, OH 44115-3111

Phone

(216) 861-6200

NPI assigned

Jun 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Emergency Professional Services, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1073550752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 LANGTON RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441211323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153111",
            "telephone_number": "216-861-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13951 Terrace Rd",
            "address_purpose": "LOCATION",
            "city": "East Cleveland",
            "state": "OH",
            "postal_code": "441124308",
            "country_code": "US",
            "telephone_number": "216-761-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNESWORTH",
        "first_name": "DOMINIC",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "OH",
            "license": "35046582",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "46583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "942460636429",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0464939",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WWW://Stvincentcharity",
            "affiliation": "N",
            "address_1": "2351 E 22nd St",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441153111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WWW.stvincentcharity.com",
            "affiliation": "N",
            "address_1": "2351 E 22nd St",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441153111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kiywan L Haynes
• Lauren Haynes, AGPCNP-C
• Neesha Haynes
• Sylvia Haynes
• Tanisha Deneen Haynes
• Dondrell L Haynesworth
• Chariscia Hays
• Erika L Hayslip, APRN
• Janet Marie Hayward, PT
• Stan Lemichael Hayward

• Emergency Medicine Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.