Organization Active NPI

Cricket Health Medical Practice of New Jersey

  • Nephrology Physician
  • Boston, MA
National Provider Identifier
1447910864
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CRICKET HEALTH MEDICAL PRACTICE OF NEW JERSEY
Practice address
68 Harrison Ave Ste 39516
Boston, MA 02111-1929
Phone
(888) 780-0253
NPI assigned
Dec 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Julie Dominguez, MDNPI 1871760223
Title
President
Phone
(833) 644-8244

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

68 Harrison Ave Ste 39516
Boston, MA 02111-1929

Mailing address

68 Harrison Ave Ste 605 PMB 39516
Boston, MA 02111-2327
Phone (833) 664-8244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA, TX, AR4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20241216002411 NY Part B Supplier - Clinic/Group Practice 7214463181 Receives reassigned benefits from 1 practitioner
Practice locations: Port Jefferson Station, NY
O20241223002119 CA Part B Supplier - Clinic/Group Practice 7214463181 Receives reassigned benefits from 1 practitioner
Practice locations: San Mateo, CA
O20250117002375 TX Part B Supplier - Clinic/Group Practice 7214463181 Receives reassigned benefits from 1 practitioner
Practice locations: Georgetown, TX
O20250211000084 AR Part B Supplier - Clinic/Group Practice 7214463181 Receives reassigned benefits from 1 practitioner
Practice locations: Vilonia, AR

National Provider Directory

National Provider Directory

Locations

1 Alewife Ctr
Ste 300A
Cambridge, MA 02140

Practitioners & affiliated clinicians

Practitioners 4

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": "1640563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1447910864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 HARRISON AVE STE 605 PMB 39516",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021112327",
            "telephone_number": "833-664-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 HARRISON AVE STE 39516",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111929",
            "telephone_number": "888-780-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRICKET HEALTH MEDICAL PRACTICE OF NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "833-644-8244",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.