Individual provider Active NPI

Robert Scott Dominguez, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Burleson, TX
National Provider Identifier
1740631548
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2384 Issued in TX
Practice address
215 Old Highway 1187
Burleson, TX 76028-0281
Phone
(817) 926-2663
Fax
(817) 293-8860
NPI assigned
Jun 23, 2016
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2384 TX Primary

Addresses

Primary practice location

215 Old Highway 1187
Burleson, TX 76028-0281

Mailing address

215 Old Highway 1187
Burleson, TX 76028-0281
Phone (817) 926-2663

Other practice location 1

167 Regency Pkwy Ste 103
Mansfield, TX 76063-6660
Phone (817) 926-2663

Other practice location 2

929 Lipscomb St
Fort Worth, TX 76104-3173
Phone (817) 926-2663

Other identifiers 1

IdentifierTypeStateIssuer
2384OtherTXTEXAS DEPARTMENT OF LICENSING AND REGULATION

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190918000064 TX Practitioner - Podiatry 6305176314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Arizona College of Osteopathic Medicine Mid Western University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Star Orthopaedic and Spine Specialists, PLLCGroup PAC ID 5597844951, 19 clinicians

Practice addresses (Care Compare)

215 Old Hwy 1187
Burleson, TX 76028-0281
Phone (817) 926-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.21 of 100Reported as group
Quality
83.88
Promoting interoperability
98
Improvement activities
40
Cost
57.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue89
Removal of nail tissue71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2384TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Orthopaedic and Spine Specialists, PLLC Foot & Ankle Surgery CurrentSince Jan 9, 2023 Accepting new patients
North Austin Foot & Ankle Institute PLLC Foot & Ankle Surgery CurrentSince Dec 6, 2021 Accepting new patients
Lone Star Orthopaedic and Spine Specialists, PLLC Foot & Ankle Surgery CurrentSince Jan 9, 2023 Accepting new patients
Kisa Health PLLC PastSince Feb 23, 2025 Accepting new patients

Locations

215 Old Highway 1187
Burleson, TX 76028
Phone 8179262663118

1130 Cottonwood Creek Trl
Ste B2
Cedar Park, TX 78613
Phone (512) 553-1771

167 Regency Pkwy
Ste 103
Mansfield, TX 76063
Phone (682) 341-7110

2681 Gattis School Rd
Ste 220
Round Rock, TX 78664
Phone (512) 843-0770

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8494/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/EABGAA

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

Hospital & facility affiliations 5

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1740631548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 OLD HIGHWAY 1187",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280281",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OLD HIGHWAY 1187",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280281",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "167 Regency Pkwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760636660",
            "country_code": "US",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "929 Lipscomb St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043173",
            "country_code": "US",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "2384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF LICENSING AND REGULATION",
            "identifier": "2384",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.