Individual provider Active NPI

Daniel J Dominguez, FNP-C

  • Family Nurse Practitioner
  • Midland, TX
National Provider Identifier
1720610447
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP145062 Issued in TX
Practice address
4214 Andrews Hwy Ste 203
Midland, TX 79703-4871
Phone
(432) 697-1000
NPI assigned
Feb 11, 2020
Last updated
Mar 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP145062 TX Primary

Addresses

Primary practice location

4214 Andrews Hwy Ste 203
Midland, TX 79703-4871

Mailing address

4214 Andrews Hwy Ste 203
Midland, TX 79703-4871

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210409000974 TX Practitioner - Nurse Practitioner 6002224144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permian Gastroenterology PAGroup PAC ID 2668699398, 3 clinicians

Practice addresses (Care Compare)

4214 Andrews Hwy
Suite 203
Midland, TX 79703-4871
Phone (432) 697-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP145062TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midland Community Healthcare Services CurrentSince Jun 1, 2022 Accepting new patients
Midland Community Healthcare Services CurrentSince Jun 1, 2022 Accepting new patients
Permian Gastroenterology, P.a. CurrentSince Dec 12, 2023 Accepting new patients

Locations

2500 Delano Ave
Midland, TX 79701
Phone (432) 697-4747

4214 Andrews Hwy
Ste 203
Midland, TX 79703
Phone (432) 697-1000

4214 Andrews Hwy
Ste 310
Midland, TX 79703
Phone (432) 697-4747

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1720610447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 ANDREWS HWY STE 203",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 ANDREWS HWY STE 203",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034871",
            "telephone_number": "432-697-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.