Individual provider Active NPI

Charlie Dominguez, FNP

  • Family Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1154883486
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140823 Issued in TX
Practice address
1521 Joe Battle Blvd
El Paso, TX 79936-0922
Phone
(915) 790-5700
NPI assigned
Apr 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 557338 NM
Family Nurse Practitioner 363LF0000X AP140823 TX Primary

Addresses

Primary practice location

1521 Joe Battle Blvd
El Paso, TX 79936-0922

Mailing address

1605 El Paseo Rd
Las Cruces, NM 88001-6010
Phone (575) 523-5400

Other practice location 1

1605 El Paseo Rd
Las Cruces, NM 88001-6010
Phone (575) 523-5400

Other names 1

  • Charlie Dominguez Professional name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191220000065 TX Practitioner - Nurse Practitioner 0042543662 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Paso County Hospital DistrictGroup PAC ID 2365431509, 208 clinicians

Practice addresses (Care Compare)

1521 Joe Battle Blvd
El Paso, TX 79936-6286
Phone (915) 760-5700

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 521-7902

4845 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 298-5444

Hospital & facility affiliations

  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
90.22
Promoting interoperability
95
Improvement activities
40
Cost
75.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
557338NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso County Hospital District CurrentSince Dec 2, 2019 Accepting new patients
Umc El Paso Healthcare Inc CurrentSince Nov 13, 2023 Accepting new patients
El Paso County Hospital District CurrentSince Dec 2, 2019 Accepting new patients

Locations

1521 Joe Battle Blvd
El Paso, TX 79936
Phone (915) 521-2200

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

4824 Alberta Ave
#4
El Paso, TX 79905

4500 N Mesa St
El Paso, TX 79912
Phone (915) 532-9000

4824 Alberta Ave
Fl 4
El Paso, TX 79905
Phone (915) 521-7103

1393 George Dieter Dr
El Paso, TX 79936
Phone (915) 228-4915

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24611/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 3

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1154883486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 EL PASEO RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880016010",
            "telephone_number": "575-523-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 JOE BATTLE BLVD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799360922",
            "telephone_number": "915-790-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1605 El Paseo Rd",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880016010",
            "country_code": "US",
            "telephone_number": "575-523-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "CHARLIE",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "557338",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLIE",
            "last_name": "DOMINGUEZ",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.