Active NPI
Deborah Ann Dominguez, CRNA
- Certified Registered Nurse Anesthetist
- Farmington, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 002045
- Practice address
- 263 Farmington Ave
Farmington, CT 06032-1956 - Phone
- (860) 679-2000
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 002045 | CT | Primary |
Addresses
Primary practice location
263 Farmington Ave
Farmington, CT 06032-1956
Mailing address
99 E River Dr FL 5
East Hartford, CT 06108-7301
Phone (860) 282-0833
Other practice location 1
99 E River Dr
5th Floor
East Hartford, CT 06108-3288
Phone (860) 282-4022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004208767 | Medicaid | CT |
Other names 1
- Deborah A Wallace
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dmurphy10416@direct.med.uchc.edu | Health Information Exchange (HIE) | |
| Direct Messaging Address | ddominguez41509@direct.med.uchc.edu | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117
Hospital & facility affiliations
- John Dempsey Hospital of the University of Connect
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Associates of Willimantic PC | Current | Accepting new patients | |
| North American Partners in Anesthesia Connecticut PC | Past | Accepting new patients |
Locations
37 Kennedy Dr
Ste C
Putnam, CT 06260
Phone (860) 423-7558
1185 Main St
Willimantic, CT 06226
Phone (860) 423-7558
1185 Main St
Ste 4
Willimantic, CT 06226
Phone (860) 423-7556
1185 Main St
Ste 2
Willimantic, CT 06226
Phone (860) 423-7558
Interoperability endpoints
- ddominguez41509@direct.med.uchc.edu
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Shelton, CT
- NPI 1881636397
-
- Anesthesiology Physician
- Willimantic, CT
- NPI 1306905799
-
- Anesthesiology Physician
- New Britain, CT
- NPI 1316994775
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Middletown, CT
- NPI 1154263713
-
- General Acute Care Hospital
- Farmington, CT
- NPI 1669466561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1689681934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 E RIVER DR FL 5",
"city": "EAST HARTFORD",
"state": "CT",
"postal_code": "061087301",
"telephone_number": "860-282-0833",
"fax_number": "860-423-4694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 FARMINGTON AVE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060321956",
"telephone_number": "860-679-2000"
}
],
"practiceLocations": [
{
"address_1": "99 E River Dr",
"address_2": "5th Floor",
"address_purpose": "LOCATION",
"city": "East Hartford",
"state": "CT",
"postal_code": "061083288",
"country_code": "US",
"telephone_number": "860-282-4022",
"fax_number": "860-289-0746",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "DEBORAH",
"middle_name": "ANN",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CT",
"license": "002045",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004208767",
"state": "CT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dmurphy10416@direct.med.uchc.edu",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "263 Farmington Ave",
"city": "Farmington",
"state": "CT",
"country_code": "US",
"postal_code": "060321956",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ddominguez41509@direct.med.uchc.edu",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "263 Farmington Ave",
"city": "Farmington",
"state": "CT",
"country_code": "US",
"postal_code": "060321956",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "DEBORAH",
"last_name": "WALLACE",
"middle_name": "A",
"credential": "CRNA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.