Individual provider Active NPI

Jessica Dominguez, MD

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1275988396
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R9482 Issued in TX
Practice address
5656 Kelley St # 4Bi70001
Houston, TX 77026-1967
Phone
(713) 566-4489
NPI assigned
Apr 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X R9482 TX Primary

Addresses

Primary practice location

5656 Kelley St # 4Bi70001
Houston, TX 77026-1967

Mailing address

5656 Kelley St # 4Bi70001
Houston, TX 77026-1967

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
I20190717002626 TX Practitioner - Internal Medicine 9234464991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

5656 Kelley St
Houston, TX 77026-1967
Phone (713) 566-5000

Hospital & facility affiliations

  • Harris Health Hospital, Houston, TX, CCN 450289

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Ut Physicians CurrentSince Jul 1, 2019 Accepting new patients
Harris County Hospital District Past Accepting new patients

Locations

5656 Kelley St
#4
Houston, TX 77026
Phone (713) 566-4489

6431 Fannin St
Ste Msb
Houston, TX 77030
Phone (713) 500-5800

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

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 1

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1275988396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 KELLEY ST # 4BI70001",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770261967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 KELLEY ST # 4BI70001",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770261967",
            "telephone_number": "713-566-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R9482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.