Individual provider Active NPI

Josefina Anita Dominguez, M.D.

  • Vascular Surgery Physician
  • Sacramento, CA
National Provider Identifier
1174949085
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A128167 Issued in CA
Practice address
2725 Capitol Ave Dept 402
Sacramento, CA 95816-6032
Phone
(916) 262-9400
Fax
(916) 262-9399
NPI assigned
Mar 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X A128167 CA Primary

Addresses

Primary practice location

2725 Capitol Ave Dept 402
Sacramento, CA 95816-6032

Mailing address

10470 Old Placerville Rd Ste 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other practice location 1

1520 San Pablo St Ste 4300
Los Angeles, CA 90033-5330
Phone (323) 442-5755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170901002873 CA Practitioner - Vascular Surgery 2668745290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

1640 E Roseville Pkwy
Suite 9
Roseville, CA 95661-3902
Phone (916) 784-2277

1655 Creekside Dr
Folsom, CA 95630-3489
Phone (916) 984-0739

1661 Creekside Dr
Folsom, CA 95630-3489
Phone (916) 984-0739

1680 E Roseville Pkwy
Suite 100
Roseville, CA 95661-3988
Phone (916) 783-8114

2 Medical Plaza Dr
Roseville, CA 95661-3042

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

3133 Professional Dr
Auburn, CA 95603-2463
Phone (530) 885-8821

3161 L St
Sacramento, CA 95816-5234
Phone (916) 453-9999

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal26
Leg revascularization (restoring blood flow)48
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
128167CAMDMarriage & Family Therapist
A128167CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 14, 2017 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 14, 2017 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

2725 Capitol Ave
Dept 402
Sacramento, CA 95816
Phone (916) 262-9400

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: jdominguez372352@hisp.ehr.sutterhealth.org

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": "1394928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174949085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 CAPITOL AVE DEPT 402",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958166032",
            "telephone_number": "916-262-9400",
            "fax_number": "916-262-9399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 San Pablo St Ste 4300",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335330",
            "country_code": "US",
            "telephone_number": "323-442-5755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JOSEFINA",
        "middle_name": "ANITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A128167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.