Diana Santo Domingo, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

C168169 Issued in CA

Practice address

3883 Airway Dr Ste 203
Santa Rosa, CA 95403-1671

Phone

(707) 521-4495

Fax

(707) 573-5421

NPI assigned

May 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Berman Skin Institute Medical Group IncGroup PAC ID 0042407215, 26 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.34 of 100Reported as group

Quality

90.85

Promoting interoperability

87

Improvement activities

40

Cost

71.11

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Berman Skin Institute Medical Group Inc

  • Dermatology Physician
  • Los Altos, CA
  • NPI 1528175528
  Medicare reassignment Care Compare group NPD
• Csi Medical Group

  • MOHS-Micrographic Surgery Physician
  • San Pedro, CA
  • NPI 1871909804

  Dermatology

  Medicare reassignment NPD

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1437350709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "707-521-4495",
            "fax_number": "707-573-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR STE 203",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031671",
            "telephone_number": "707-521-4495",
            "fax_number": "707-573-5421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 N Flamingo Rd",
            "address_2": "Suite 350",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281013",
            "country_code": "US",
            "telephone_number": "216-844-7834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9460 N Name Uno Ste 210",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "950203532",
            "country_code": "US",
            "telephone_number": "408-847-0888",
            "fax_number": "408-847-1257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTO DOMINGO",
        "first_name": "DIANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "997612",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C168169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "C168169",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregorio Omar Santiago
• Jayson Geronimo Santiago
• Katrina Santiago, M.A. CCC-SLP
• Roseanna Marie Santiago
• Jocelyne Santibanez Regalado
• Paola Jessica Santos Perez
• Danielle Renee Santos, ASW
• Jennifer Anne Santos, MFT INTERN
• Rudy Y Santos, MD
• Claudia Alexandra Santucci, M.D.

• Dermatology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.