Individual provider Active NPI

Leonardo Dominguez, M.D.

  • Ophthalmology Physician
  • Lubbock, TX
National Provider Identifier
1114917424
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
44328 Issued in TX
Practice address
3601 4TH St
2A100
Lubbock, TX 79430-0002
Phone
(806) 743-2020
Fax
(806) 743-1782
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 44328 TX Primary

Addresses

Primary practice location

3601 4TH St
2A100
Lubbock, TX 79430-0002

Mailing address

PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898

Other identifiers 11

IdentifierTypeStateIssuer
100846300AMedicaidOK
71180036MedicaidNM
79540OtherNMPRESBYTERIAN COMMERCIAL
131456101MedicaidTX
131456100OtherTXFIRSTCARE COMMERCIAL
154559202MedicaidTX
154559201MedicaidTX
8G7980OtherTXBC/BS
B017OtherNMTRIWEST
79540MedicaidNM
86979ZOtherTXHMO BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090616000559 TX Practitioner - Ophthalmology 1850441676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9436
Phone (806) 743-2475

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Oct 10, 2002 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Ophthalmology CurrentSince Oct 10, 2002 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

3601 4th St
Ste 2A100
Lubbock, TX 79430
Phone (806) 743-2020

3601 4th St
#2A100
Lubbock, TX 79430
Phone (281) 455-8955

4004 82nd St
Ste 200
Lubbock, TX 79423
Phone (806) 743-7676

3601 4th St
Ste 3A101
Lubbock, TX 79430
Phone (806) 743-2018

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

Organizations & group practices 5

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 5

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1114917424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5865",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794085865",
            "telephone_number": "806-743-2898",
            "fax_number": "806-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "2A100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-2020",
            "fax_number": "806-743-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "LEONARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "44328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100846300A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71180036",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN COMMERCIAL",
            "identifier": "79540",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131456101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE COMMERCIAL",
            "identifier": "131456100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154559202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154559201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8G7980",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "B017",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79540",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE",
            "identifier": "86979Z",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.