Ruth K Dominguez Enriquez, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00766000 Issued in NJ

Practice address

200 Highland Ave Ste 100B
Glen Ridge, NJ 07028-1521

Phone

(973) 969-3800

Fax

(833) 488-1213

NPI assigned

Feb 13, 2023

Sex

Female

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 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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vanguard Medical Group PAGroup PAC ID 5092751842, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25493/brand/1/csg/1/fhir/r4
• Direct secure messaging: ruth.dominguez.enriquez.2@25493.direct.athenahealth.com

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.

• Vanguard Medical Group, PA

  • Family Medicine Physician
  • Verona, NJ
  • NPI 1073674412
  Medicare reassignment Care Compare group
• Primary Care for the Homebound PA

  • Home Health Agency
  • Verona, NJ
  • NPI 1609206671
  NPD

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1598462228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 GROVE AVE STE E",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441730",
            "telephone_number": "973-559-3700",
            "fax_number": "833-484-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGHLAND AVE STE 100B",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281521",
            "telephone_number": "973-969-3800",
            "fax_number": "833-488-1213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "271 Grove Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "070441731",
            "country_code": "US",
            "telephone_number": "973-239-2600",
            "fax_number": "833-495-1921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ ENRIQUEZ",
        "first_name": "RUTH",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00766000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis a Tobia MD PA
• Christopher Di Giorgio, MD
• Karen Arlene Dias-Martin, M.D.
• Paul L Dionne
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• Gerald Mario Esposito, LCSW
• Leide Etienne
• Kaitlyn Ettinger
• Sara E. Every, L.C.S.W.
• Joelle Falaise

• Physician Assistant in Glen Ridge, NJ
• Providers in Glen Ridge, 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 Apr 16, 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.