Individual provider Active NPI

Maria Hoeller Dominguez, M.D.

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1548615628
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
330336 Issued in LA
Practice address
1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone
(318) 681-4500
NPI assigned
Apr 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 330336 LA Primary

Addresses

Primary practice location

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other practice location 1

525 E 68th St
New York, NY 10065-4870
Phone (212) 746-0433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, LA, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200829000124 NY Practitioner - Emergency Medicine 2860819398 Reassigns benefits to 1 organization
I20220506001367 LA Practitioner - Emergency Medicine 2860819398 Reassigns benefits to 5 organizations
I20241015004241 FL Practitioner - Emergency Medicine 2860819398 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians
St Tammany Emergency Physicians Group LLCGroup PAC ID 7214255967, 41 clinicians

Practice addresses (Care Compare)

2020 59TH St W
Blake Medical Center
Bradenton, FL 34209-4604
Phone (941) 792-6611

211 4TH St
Alexandria, LA 71301-8421
Phone (318) 769-3000

Hospital & facility affiliations

  • Rapides Regional Medical Center Hospital, Alexandria, LA, CCN 190026
  • HCA Florida Fawcett Hospital Hospital, Port Charlotte, FL, CCN 100236
  • HCA Florida Blake Hospital Hospital, Bradenton, FL, CCN 100213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
330336LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Oct 25, 2024 Accepting new patients
St Tammany Emergency Physicians Group LLC Emergency Medicine CurrentSince Feb 7, 2025 Accepting new patients
Highland Emergency Group, LLC Emergency Medicine CurrentSince Mar 28, 2022 Accepting new patients
Riverside Emergency Physician Partners LLC Emergency Medicine CurrentSince Nov 1, 2023 Accepting new patients
Southwest Florida Emergency Management LLC Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Thse - Marco Urgent Care LLC CurrentSince Oct 1, 2024 Accepting new patients
Delaware River Medicine, PLLC Emergency Medicine CurrentSince Jun 19, 2020 Accepting new patients
Professional Emergency Physician Associates, LLC Emergency Medicine CurrentSince Jul 9, 2022 Accepting new patients
Professional Emergency Medicine Management -- Lake Charles LLC Emergency Medicine CurrentSince Jul 13, 2022 Accepting new patients

Locations

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

40 S Heathwood Dr
Marco Island, FL 34145
Phone (239) 393-4079

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

Dept AT952639
Atlanta, GA 31192

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

200 Corporate Blvd
Lafayette, LA 70508

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

3983 I 49 S Service Rd
Opelousas, LA 70570
Phone (337) 407-4512

539 E Prudhomme St
Opelousas, LA 70570
Phone (337) 943-7128

1900 Main St
Sheridan, LA 70438
Phone (985) 839-4431

1453 E Bert Kouns Industrial Loop
#L
Shreveport, LA 71105

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

160 E Main St
Port Jervis, NY 12771
Phone (845) 856-7000

15 Maple Ave
Warwick, NY 10990
Phone (845) 986-2224

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 9

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1548615628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056800",
            "telephone_number": "318-681-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E 68th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100654870",
            "country_code": "US",
            "telephone_number": "212-746-0433",
            "fax_number": "212-746-0887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MARIA",
        "middle_name": "HOELLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2022-04-28",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "330336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.