Individual provider Active NPI

Michael Joseph Dominguez, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1689674509
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J8520 Issued in TX
Practice address
590 N General McMullen
Suite 1
San Antonio, TX 78228-6205
Phone
(210) 249-0212
Fax
(210) 249-0217
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J8520 TX Primary

Addresses

Primary practice location

590 N General McMullen
Suite 1
San Antonio, TX 78228-6205

Mailing address

2961 Mossrock
San Antonio, TX 78230-5119
Phone (210) 731-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20050825000452 TX Practitioner - Family Practice 6103857594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Primecare, IncGroup PAC ID 8628073236, 70 clinicians

Practice addresses (Care Compare)

590 N General McMullen
1 Physician Primecare Holy Cross
San Antonio, TX 78228-6205
Phone (210) 249-0212

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince May 1, 2015 Accepting new patients
Ucp Physicians of Central Texas, PLLC Current Accepting new patients
Physician Primecare, Inc Family Medicine CurrentSince Feb 15, 2010 Accepting new patients
Community Medicine Associates Family Medicine PastSince Aug 1, 2006 Accepting new patients

Locations

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

911 Castroville Rd
San Antonio, TX 78237
Phone (210) 436-7402

2911 S New Braunfels Ave
San Antonio, TX 78210
Phone (210) 377-1133

2961 Mossrock
San Antonio, TX 78230
Phone (210) 731-4800

590 N General McMullen Dr
Ste 1
San Antonio, TX 78228
Phone (210) 249-0212

16755 Huebner Rd
San Antonio, TX 78248
Phone (210) 493-4357

Interoperability endpoints

  • Direct secure messaging: michael.dominguez@htmg.eclinicaldirectplus.com

Organizations & group practices 4

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689674509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 MOSSROCK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305119",
            "telephone_number": "210-731-4800",
            "fax_number": "210-731-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 N GENERAL MCMULLEN",
            "address_2": "SUITE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782286205",
            "telephone_number": "210-249-0212",
            "fax_number": "210-249-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J8520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.