Alexander Domingo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD190545 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Ohsu
Portland, OR 97239-3011

Phone

(503) 494-8211

NPI assigned

Mar 30, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Yale University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adomingomd101762@direct.ohsu.edu

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.

• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment Care Compare group NPD
• Oregon Health & Science University

  dba OHSU Scappoose Rural Health Clinic

  • Rural Health Clinic/Center
  • Scappoose, OR
  • NPI 1417969304
  Medicare reassignment NPD
• Oregon Health & Science University

  dba Ohsu East Portland Pharmacy

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1457129678
  NPD
• Oregon Health & Science University

  dba OHSU Family Medicine at Richmond Walk-In Clinic

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1487902706
  NPD
• University Professional Services

  dba OHSU Home Infusion Pharmacy

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD
• University Professional Services

  dba OHSU Intercultural Psychiatric Program

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1750753687
  NPD
• University Professional Services

  dba University Professional Services in Medford

  • Pediatrics Physician
  • Medford, OR
  • NPI 1225282122
  NPD (past)

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

• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1528590494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "OHSU",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "ALEXANDER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2022-02-14",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD190545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10100 SE Sunnyside Rd",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970158970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robyn Ashley Dolson, PHD
• Lindsey Domanico
• Shira Heather Dombiak, MA LPC
• Natasha Maria Dombrowski
• Nicholas Domenichini, PSS
• Leonila Domingo, RN, BSN
• Liberato A Domingo, BSN
• Melba Domingo, CEO
• Flora Dominguez Zarate, THW DOULA
• Roman Dominguez-Soto

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.