Organization Active NPI

Healthy You

  • Family Medicine Physician
  • Gilbert, AZ
National Provider Identifier
1407472467
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTHY YOU
Practice address
1760 E Pecos Rd Ste 431
Gilbert, AZ 85295-3209
Phone
(480) 237-3451
Fax
(480) 499-5666
NPI assigned
Jun 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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

Authorized official

Name
Omar L. Dominique, MDNPI 1770996050
Title
Owner/President
Phone
(872) 212-7966

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1760 E Pecos Rd Ste 431
Gilbert, AZ 85295-3209

Mailing address

1760 E Pecos Rd Ste 431
Gilbert, AZ 85295-3209
Phone (872) 212-7966

Other practice location 1

9700 N 91st St Ste A115
Scottsdale, AZ 85258-5036
Phone (480) 770-3967

Other practice location 2

7828 S Hoyne Ave
Chicago, IL 60620-5741
Phone (480) 770-3967

Other identifiers 2

IdentifierTypeStateIssuer
1770996050OtherMSNPI
02887009MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200724000601 AZ Part B Supplier - Clinic/Group Practice 2264856137 Receives reassigned benefits from 1 practitioner
Practice locations: Queen Creek, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2309021Healthy You Primary Care1760 E Pecos Rd Ste 431, Gilbert, AZ 85295Certificate of waiverAug 7, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736553600000",
    "number": "1407472467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 E PECOS RD STE 431",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852953209",
            "telephone_number": "872-212-7966",
            "fax_number": "480-499-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E PECOS RD STE 431",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852953209",
            "telephone_number": "480-237-3451",
            "fax_number": "480-499-5666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9700 N 91st St Ste A115",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852585036",
            "country_code": "US",
            "telephone_number": "480-770-3967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7828 S Hoyne Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606205741",
            "country_code": "US",
            "telephone_number": "480-770-3967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTHY YOU",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A",
        "authorized_official_last_name": "DOMINIQUE",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "872-212-7966",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770996050",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02887009",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.