NPIMap

Individual provider Active NPI

Jonathan Manuel Dominguez, M.D.

  • Family Medicine Physician
  • North Bergen, NJ
National Provider Identifier
1376923755
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA10256200 Issued in NJ
Practice address
7919 Kennedy Blvd
North Bergen, NJ 07047-4137
Phone
(201) 528-3664
Fax
(201) 528-3662
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA10256200 NJ Primary

Addresses

Primary practice location

7919 Kennedy Blvd
North Bergen, NJ 07047-4137

Mailing address

7919 Kennedy Blvd
North Bergen, NJ 07047-4137
Phone (201) 528-3664

Other practice location 1

219 60th St
West New York, NJ 07093-6429
Phone (201) 528-3664

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
I20200113000028 NJ Practitioner - Family Practice 4688914765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Medical Group of New JerseyGroup PAC ID 4082979166, 299 clinicians

Practice addresses (Care Compare)

7919 Kennedy Blvd
North Bergen, NJ 07047-4137
Phone (201) 528-3664

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients
Domi Healthcare LLC Family Medicine CurrentSince Dec 11, 2023 Accepting new patients
The Radiology Group of New Jersey, LLC CurrentSince Oct 14, 2024 Accepting new patients
Holy Name Medical Center Inc. Past Accepting new patients
Monmouth Digestive Health LLC PastSince Aug 17, 2020 Accepting new patients

Locations

145 Wyckoff Rd
Ste 201
Eatontown, NJ 07724
Phone (732) 597-7333

57 US Highway 46
Ste 212
Hackettstown, NJ 07840

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

175 High St
Newton, NJ 07860
Phone (973) 383-2121

222 High St
Ste 205
Newton, NJ 07860
Phone (973) 579-4060

7919 Kennedy Blvd
North Bergen, NJ 07047
Phone (201) 351-3177

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

Interoperability endpoints

  • Direct secure messaging: jonathan.dominguez@721973079769092.direct.elationemr.com
  • Direct secure messaging: jonathan.dominguez@direct.hobokenumc.md

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 8

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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1376923755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7919 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070474137",
            "telephone_number": "201-528-3664",
            "fax_number": "201-528-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7919 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070474137",
            "telephone_number": "201-528-3664",
            "fax_number": "201-528-3662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 60th St",
            "address_purpose": "LOCATION",
            "city": "West New York",
            "state": "NJ",
            "postal_code": "070936429",
            "country_code": "US",
            "telephone_number": "201-528-3664",
            "fax_number": "201-528-3664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JONATHAN",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10256200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

Verify at the official NPI Registry.