Individual provider Active NPI

Matthew Lee Dominguez, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1609119353
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
290023 Issued in NY
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

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
NAOtherNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180709002503 NY Practitioner - Psychiatry 4981906351 Reassigns benefits to 7 organizations
I20220617001167 TX Practitioner - Psychiatry 4981906351 Reassigns benefits to 1 organization

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
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

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 Hospital, Bronx, NY, CCN 330080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0361390776ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2018 Accepting new patients
The Fifth Avenue Counseling Center, Inc. CurrentSince Jun 1, 2002 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Feb 1, 2025 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jul 1, 2022 Accepting new patients
New York University CurrentSince Jul 14, 2024 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Mar 1, 2020 Accepting new patients
New York University CurrentSince Jul 14, 2024 Accepting new patients
Kings Physician Services, PC CurrentSince May 26, 2020 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Feb 1, 2025 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2018 Accepting new patients
Kings Physician Services, PC CurrentSince May 26, 2020 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

  • Direct secure messaging: mdominguez663850@nyumc.direct-ci.com
  • Direct secure messaging: 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.

View all 15

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.