Active NPI
Matthew Lee Dominguez, M.D.
- Psychiatry Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 290023
- Practice address
- 550 1St Ave
New York, NY 10016-6402 - Phone
- (212) 263-7264
- Fax
- (212) 263-8525
- NPI assigned
- Apr 1, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 193103 | AK | |
| Psychiatry Physician | 2084P0800X | 0361390776 | IL | |
| Psychiatry Physician | 2084P0800X | 290023 | NY | Primary |
Addresses
Primary practice location
550 1St Ave
New York, NY 10016-6402
Mailing address
550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7264
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Northwestern University Feinberg Medical School, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
234 E 149 St
Bronx, NY 10451-5504
Phone (718) 579-6101
2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356
Hospital & facility affiliations
- Lincoln Medical & Mental Health Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0361390776 | IL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| The Fifth Avenue Counseling Center, Inc. | Current | Accepting new patients | |
| New York City Health and Hospitals Corporation | Current | Accepting new patients | |
| Alaska Native Tribal Health Consortium | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Physician Affiliate Group of New York PC | Current | Accepting new patients | |
| Downtown Bronx Medical Associates PC | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Kings Physician Services, PC | Current | Accepting new patients | |
| New York City Health and Hospitals Corporation | Current | Accepting new patients | |
| New York City Health and Hospitals Corporation | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Kings Physician Services, PC | Current | Accepting new patients | |
| Southcentral Foundation | Past | Accepting new patients | |
| Southcentral Foundation | Past | Accepting new patients |
Locations
4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729
4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000
234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874
506 6th St
Fl 6
Brooklyn, NY 11215
Phone (718) 780-5130
506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677
2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354
7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156
8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929
5 E 17th St
Fl 2
New York, NY 10003
Phone (212) 989-2900
550 1st Ave
New York, NY 10016
Phone (212) 263-3293
50 Water St
Fl 3
New York, NY 10004
1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150
506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Interoperability endpoints
- mdominguez663850@nyumc.direct-ci.com
- mdominguez3493626@nychhc.direct-ci.com
Organizations & group practices 15
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.
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bronx, NY
- NPI 1689618407
-
- Addiction Medicine (Psychiatry & Neurology) Physician
- New York, NY
- NPI 1033482518
-
- Diagnostic Radiology Physician
- Brooklyn, NY
- NPI 1083045090
-
- Clinic/Center
- New York, NY
- NPI 1548208127
-
- Community/Behavioral Health Agency
- New York, NY
- NPI 1801037270
-
- Eyewear Supplier
- New York, NY
- NPI 1760227466
-
- Emergency Medicine Physician
- Brooklyn, NY
- NPI 1326698879
-
- Clinic/Center
- Bronx, NY
- NPI 1003824608
-
- Clinic/Center
- New York, NY
- NPI 1538943469
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1427063270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1609119353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100166402",
"telephone_number": "212-263-7264",
"fax_number": "212-263-8525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100166402",
"telephone_number": "212-263-7264",
"fax_number": "212-263-8525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "MATTHEW",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-01",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AK",
"license": "193103",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "0361390776",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "290023",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.