Ivan Dominguez, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME134038 Issued in FL

Practice address

680 N University Dr
Pembroke Pines, FL 33024

Phone

(954) 981-2555

NPI assigned

Jun 1, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

General Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastside Hospitalists IncGroup PAC ID 9436157831, 179 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
• Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
• Douglas Gardens Hospital Hospital, Miami, FL, CCN 100277

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: idominguezcasillas227633@mhsdirect.net

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.

• Eastside Hospitalists Inc

  • Hospitalist Physician
  • Hollywood, FL
  • NPI 1285676957
  Medicare reassignment Care Compare group NPD
• Florida Hospital Medicine Services, LLC.

  • Hospitalist Physician
  • Boca Raton, FL
  • NPI 1508873183
  Medicare reassignment NPD
• Miami Jewish Health Systems, Inc.

  • General Acute Care Hospital
  • Miami, FL
  • NPI 1851440218
  Medicare reassignment NPD
• Yill Health LLC

  • Family Medicine Physician
  • Miami, FL
  • NPI 1912683970
  NPD (past)

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

• Miami Jewish Health Systems, Inc.

  • General Acute Care Hospital
  • Miami, FL
  • NPI 1851440218
  Care Compare affiliation
• South Broward Hospital District

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1134102080
  Care Compare affiliation
• South Broward Hospital District

  • General Acute Care Hospital
  • Hollywood, FL
  • NPI 1780667923
  Care Compare affiliation

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1609256072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14421 SW 10TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331843114",
            "telephone_number": "786-508-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-981-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "IVAN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME134038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "idominguezcasillas227633@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "703 N Flamingo Rd",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330281006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Eric Dolberg, M.D.
• Andrea M Dolinish
• Lisset Domenech
• Pedro Enrique Dominguez Santana
• Ayme Dominguez
• Jose Dumergue Dominguez, DDS
• Clafdia Nathalie Dominique
• Meryl Donaldson
• Adrienne Emily Donawa
• Jean Donne

• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.