NPIMap

Individual provider Active NPI

Robert Javier Dominguez, M.D.

  • Emergency Medicine Physician
  • Lancaster, OH
National Provider Identifier
1619965472
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35053076D Issued in OH
Practice address
784 E Main St
Lancaster, OH 43130-3983
Phone
(740) 687-0100
Fax
(740) 687-0145
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35053076D OH Primary
Family Medicine Physician 207Q00000X 35053076D OH
General Practice Physician 208D00000X 35053076D OH

Addresses

Primary practice location

784 E Main St
Lancaster, OH 43130-3983

Mailing address

784 E Main St
Lancaster, OH 43130-3983
Phone (740) 687-0100

Other identifiers 2

IdentifierTypeStateIssuer
0613161MedicaidOH
35053076DOtherOHOHIO MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041228000771 OH Practitioner - Emergency Medicine 6901864602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
76.95 of 100Reported as group
Quality
43.39
Promoting interoperability
100
Improvement activities
40
Cost
76.51

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
87.11
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Healthcare Professionals, Inc. CurrentSince Sep 6, 2020 Accepting new patients
Emergency Medicine Physicians of Lancaster, LTD. Emergency Medicine CurrentSince Jan 1, 2014 Accepting new patients
Fairfield Healthcare Professionals Inc Current Accepting new patients
Columbus Radiology Corp Past Accepting new patients
Fairfield Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Fairfield ER Physicians Dba Fairfield Medical Center Pro Fee Emergency Medicine Past Accepting new patients
Fairfield Medical Center Past Accepting new patients
Eastwood Health and Wellness Center Inc Past Accepting new patients
Regional Occupational Health Clinics, LLC Family Medicine PastSince Jan 8, 2014 Accepting new patients

Locations

1055 W Market St
Ste H
Baltimore, OH 43105
Phone (740) 277-6043

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

1155 E Main St
Lancaster, OH 43130
Phone (740) 277-6043

216 Trace Dr
Lancaster, OH 43130
Phone (740) 277-6043

1201 River Valley Blvd
Lancaster, OH 43130
Phone (740) 303-4300

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1619965472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303983",
            "telephone_number": "740-687-0100",
            "fax_number": "740-687-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303983",
            "telephone_number": "740-687-0100",
            "fax_number": "740-687-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "ROBERT",
        "middle_name": "JAVIER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35053076D",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35053076D",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35053076D",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0613161",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAL LICENSE",
            "identifier": "35053076D",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.