NPIMap

Individual provider Active NPI

Dominic Pamintuan, MD

  • Internal Medicine Physician
  • Fair Haven, NJ
National Provider Identifier
1124034897
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08618100 Issued in NJ
Practice address
569 River Rd
Fair Haven, NJ 07704-3262
Phone
(732) 530-0100
Fax
(732) 530-5895
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08618100 NJ Primary

Addresses

Primary practice location

569 River Rd
Fair Haven, NJ 07704-3262

Mailing address

PO Box 8519
Red Bank, NJ 07701-8519
Phone (732) 460-9840

Other identifiers 3

IdentifierTypeStateIssuer
611521901OtherVAUS DEPT OF LABOR
611521902OtherVAUS DEPT OF LABOR
611521900OtherVAUS DEPT OF LABOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100503000034 NJ Practitioner - Internal Medicine 7517963291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medicine Alliance PAGroup PAC ID 2668468919, 41 clinicians

Practice addresses (Care Compare)

1026 Broad St
Unit 18
Shrewsbury, NJ 07702-4380
Phone (732) 460-9840

Hospital & facility affiliations

  • Hackensack Meridian at Home Monmouth County Home health agency, Neptune, NJ, CCN 317084
  • Visiting Nurse Association of Central Jersey Home Care and Hospice Home health agency, Toms River, NJ, CCN 317067
  • Riverview Medical Center Hospital, Red Bank, NJ, CCN 310034
  • Monmouth Medical Center Hospital, Long Branch, NJ, CCN 310075
  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • Bayshore Medical Center Hospital, Holmdel, NJ, CCN 310112

Merit-based Incentive Payment System (MIPS)

Final score
81.97 of 100Reported as group
Quality
69.67
Promoting interoperability
94
Improvement activities
40
Cost
75.23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ima Urgent Care Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dominic.pamintuan@ima.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71872

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1124034897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8519",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077018519",
            "telephone_number": "732-460-9840",
            "fax_number": "732-460-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 RIVER RD",
            "city": "FAIR HAVEN",
            "state": "NJ",
            "postal_code": "077043262",
            "telephone_number": "732-530-0100",
            "fax_number": "732-530-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAMINTUAN",
        "first_name": "DOMINIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08618100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "611521901",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "611521902",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "611521900",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Haven, NJ

Sources for this page

Verify at the official NPI Registry.