NPIMap

Individual provider Active NPI

Edward Paul Dominguez, M D

  • Surgery Physician
  • Columbus, OH
National Provider Identifier
1467400697
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M2308 Issued in TX
Practice address
3545 Olentangy River Rd
Suite 525
Columbus, OH 43214-3907
Phone
(614) 261-1900
Fax
(614) 261-7538
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M2308 TX Primary

Addresses

Primary practice location

3545 Olentangy River Rd
Suite 525
Columbus, OH 43214-3907

Mailing address

2595 Marblevista Blvd
Columbus, OH 43204-9012
Phone (614) 261-1900

Other identifiers 1

IdentifierTypeStateIssuer
2664620MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edominguez33569@direct.ohiohealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060728000355 OH Practitioner - General Surgery 1658384110 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Ohio State University College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians
Riverside Trauma Surgeons LLCGroup PAC ID 9931132040, 9 clinicians
Riverside Surgical Associates IncGroup PAC ID 9537192950, 9 clinicians

Practice addresses (Care Compare)

3535 Olentangy River Rd
Columbus, OH 43214-3908
Phone (614) 566-5283

3545 Olentangy River Rd
Suite 525
Columbus, OH 43214-3907
Phone (614) 261-1900

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Ohiohealth Mansfield Hospital Hospital, Mansfield, OH, CCN 360118
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M2308TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Surgical Associates Inc Surgery CurrentSince Jul 17, 2006 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 17, 2009 Accepting new patients
Riverside Trauma Surgeons LLC CurrentSince Sep 1, 2006 Accepting new patients
Ohiohealth Corporation Current Accepting new patients
Ohiohealth Corporation CurrentSince Oct 17, 2009 Accepting new patients
Ohiohealth Corporation Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

3545 Olentangy River Rd
Ste 525
Columbus, OH 43214
Phone (614) 261-1900

3545 Olentangy River Rd
Ste 226
Columbus, OH 43214
Phone (614) 261-0174

Dept L3652
Columbus, OH 43260

Organizations & group practices 7

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 5

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1467400697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 MARBLEVISTA BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432049012",
            "telephone_number": "614-261-1900",
            "fax_number": "614-261-7538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 OLENTANGY RIVER RD",
            "address_2": "SUITE 525",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143907",
            "telephone_number": "614-261-1900",
            "fax_number": "614-261-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "EDWARD",
        "middle_name": "PAUL",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "M2308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2664620",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edominguez33569@direct.ohiohealth.com",
            "affiliation": "N",
            "address_1": "3545 Olentangy River Rd",
            "address_2": "SUITE 525",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.