NPIMap

Individual provider Active NPI

Oscar G Dominguez, M.D.

  • Nephrology Physician
  • Parker, CO
National Provider Identifier
1104892272
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
DR0037995 Issued in CO
Practice address
9397 Crown Crest Blvd.
Suite 401
Parker, CO 80138-8575
Phone
(303) 697-1636
Fax
(303) 805-9948
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X DR0037995 CO Primary

Addresses

Primary practice location

9397 Crown Crest Blvd.
Suite 401
Parker, CO 80138-8575

Mailing address

9397 Crown Crest Blvd.
Suite 401
Parker, CO 80138-8575
Phone (303) 697-1636

Other identifiers 1

IdentifierTypeStateIssuer
74724797MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040707000156 CO Practitioner - NephrologyPractitioner - Internal Medicine 2961489042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
New York Medical College, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9397 Crown Crest Blvd
Suite 401
Parker, CO 80138-8789
Phone (303) 697-1636

Hospital & facility affiliations

  • AdventHealth Parker Hospital, Parker, CO, CCN 060114
  • Adventhealth Castle Rock Hospital, Castle Rock, CO, CCN 060125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0037995COMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Nephrology and Hypertension Professional LLC Nephrology CurrentSince Aug 25, 2004 Accepting new patients
Consultants in Nephrology and Hypertension Professional LLC Nephrology CurrentSince Aug 25, 2004 Accepting new patients
Critical Care Pulmonary and Sleep Associates Professional LLP PastSince Jun 8, 2025 Accepting new patients
Critical Care Pulmonary and Sleep Associates Professional LLP PastSince Jul 1, 2002 Accepting new patients

Locations

4350 Limelight Ave
Unit 250
Castle Rock, CO 80109
Phone (303) 697-1636

9397 Crown Crest Blvd
Ste 401
Parker, CO 80138
Phone (303) 407-7920

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1104892272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9397 CROWN CREST BLVD.",
            "address_2": "SUITE 401",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388575",
            "telephone_number": "303-697-1636",
            "fax_number": "303-805-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9397 CROWN CREST BLVD.",
            "address_2": "SUITE 401",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388575",
            "telephone_number": "303-697-1636",
            "fax_number": "303-805-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "OSCAR",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "DR0037995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74724797",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.