Jesse Serrano Dominguez, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A8942 Issued in CA

Practice address

16839 Ramona Ave Ste 401
Fontana, CA 92336-2014

Phone

(909) 429-2864

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Family Practice

Education

Western University of Health Sciences College of Dental Med, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cucamonga Valley Medical Group IncGroup PAC ID 6709899883, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18095/brand/2/csg/1/fhir/r4

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.

• Cucamonga Valley Medical Group, Inc.

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1497783229
  Medicare reassignment Care Compare group NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • Santa Ana, CA
  • NPI 1740519081
  Medicare reassignment NPD
• Mountain View Urgent Care Group, Inc

  • Emergency Medicine Physician
  • Fontana, CA
  • NPI 1023306784
  Medicare reassignment NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • Rancho Cucamonga, CA
  • NPI 1487959581
  NPD
• Mountain View Urgent Care Group, Inc

  • Emergency Medicine Physician
  • Pomona, CA
  • NPI 1801233036
  NPD
• KND Development 59, LLC

  • Hospitalist Physician
  • Broken Arrow, OK
  • NPI 1922950823
  NPD
• Primecare Medical Group

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1093720427
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  Care Compare affiliation

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1467534313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16839 RAMONA AVE STE 401",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923362014",
            "telephone_number": "909-429-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16839 RAMONA AVE STE 401",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923362014",
            "telephone_number": "909-429-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JESSE",
        "middle_name": "SERRANO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy DO
• Leandra L Doan, MD
• Thien T. Doan, MD
• Paul C. Doehring, MD
• Angeline Loberiano Domagat, NP
• Matthew Robert Dominguez, DC
• Don'S Acupuncture Clinic
• Helen M Donovan, PA
• Doulajustinallc
• Linda D. Dow, MD

• Family Medicine Physician in Fontana, CA
• Providers in Fontana, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.