Mario L Dominguez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

151294 Issued in MA

Practice address

1690 Main St
Suite 4
South Weymouth, MA 02190-1279

Phone

(781) 337-8688

Fax

(781) 337-8754

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MA

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

Family Practice

Education

University of California, San Francisco School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Shore Visiting Nurse Association Home health agency, Rockland, MA, CCN 227082
• Bayada Home Health Care Inc Home health agency, Plymouth, MA, CCN 227537
• Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
• Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
• South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdominguez253864@direct.bilh.masshiway.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.

• Medical Care of Boston Management Corporation

  • Internal Medicine Physician
  • Needham, MA
  • NPI 1437196359
  Medicare reassignment Care Compare group NPD
• Harbor Medical Associates, Inc.

  • Diagnostic Radiology Physician
  • S. Weymouth, MA
  • NPI 1689909723
  NPD (past)
• Jordan Physician Associates, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Plymouth, MA
  • NPI 1194263186
  NPD (past)
• Jordan Physician Associates, Inc.

  • Family Medicine Physician
  • Plymouth, MA
  • NPI 1538145131
  NPD (past)

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

• South Shore Hospital Inc.

  • Home Health Agency
  • Braintree, MA
  • NPI 1669558474
  Care Compare affiliation Name & address match
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Plymouth, MA
  • NPI 1366481293
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • South Easton, MA
  • NPI 1811257694
  Care Compare affiliation
• Beth Israel Deaconess Hospital Plymouth, Inc.

  • General Acute Care Hospital
  • Plymouth, MA
  • NPI 1043299001
  Care Compare affiliation
• Beth Israel Deaconess Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1548202641
  Care Compare affiliation
• South Shore Hospital Inc.

  • General Acute Care Hospital
  • South Weymouth, MA
  • NPI 1134227606
  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1609807874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 MAIN ST",
            "address_2": "SUITE 4",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901279",
            "telephone_number": "781-337-8688",
            "fax_number": "781-337-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 MAIN ST",
            "address_2": "SUITE 4",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901279",
            "telephone_number": "781-337-8688",
            "fax_number": "781-337-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MARIO",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "151294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAHP",
            "identifier": "151274",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN #",
            "identifier": "BX6466",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "J17080",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3153517",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "71156",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Deppe
• Neil Himansu Desai, MS, PA-C
• Savitha Devi, MD
• Melissa Anne Dinunno, CNM
• Mary E. Doherty, NP
• Katelyn McGovern Dorney, MD
• Shannon Doucette, MS BCBA LABA
• Michael N Doupe, MD
• Kieran Dowley
• Patrick Doyle

• Family Medicine Physician in South Weymouth, MA
• Providers in South Weymouth, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.