Jessica Dominguez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00812900 Issued in NJ

Practice address

1135 Main Ave
Clifton, NJ 07011-2353

Phone

(973) 928-3388

NPI assigned

Oct 18, 2023

Last updated

Dec 27, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ACFEBA
• FHIR API: https://fhir4.healow.com/fhir/r4/ACFEBA/Endpoint/ACFEBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MD Care Clinic LLC

  • Internal Medicine Physician
  • Clifton, NJ
  • NPI 1659911287
  Medicare reassignment
• Fayrouz Pediatric LLC

  • Pediatrics Physician
  • Paterson, NJ
  • NPI 1154571222
  NPD (past)
• Pioneer Medical Care Group LLC

  • Internal Medicine Physician
  • Clifton, NJ
  • NPI 1083481188
  NPD (past)

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1518749092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 HOPE AVE APT 2",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070556707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 MAIN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112353",
            "telephone_number": "973-928-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030723",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00812900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J Doerr, M.D.
• Husniye Dogan, D.D.S
• Edward L Doktorman, DDS
• Domingo Yang Jr MD PC
• Anthony Dominguez
• Donald H Green MD PA
• Brian Donovan, DC
• Doorways Outreach
• Jennifer Dour, DC
• Devin Douvier

• Physician Assistant in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.