Domingo Nieves Jr., CLINICAL COORDINATOR

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2225 Main St.
Springfield, MA 01107

Phone

(413) 733-3488

Fax

(413) 731-7381

NPI assigned

Jul 13, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Domingo Nieves Jr. Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Habit Opco

  • Addiction (Substance Use Disorder) Counselor
  • Springfield, MA
  • NPI 1457786808
  NPD (past)

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1740702547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071905",
            "telephone_number": "413-733-3488",
            "fax_number": "413-731-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 MAIN ST.",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01107",
            "telephone_number": "413-733-3488",
            "fax_number": "413-731-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "DOMINGO",
        "name_suffix": "Jr.",
        "credential": "CLINICAL COORDINATOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3080010",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1301829",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMINGO",
            "last_name": "NIEVES",
            "suffix": "JR.",
            "credential": "CLINICAL COORDINATOR",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cheryl Rose Nicosia
• Erika Niergarth
• Raysa Nieto Davila
• Vanessa Nieves-Rivera
• Azahria Nieves
• Glenda Nieves
• Karla Nieves
• Sara Nigro, PA-C
• Janhvi Rajesh Nimbalkar, M.D.
• Anna Nishimwe

• Addiction (Substance Use Disorder) Counselor in Springfield, MA
• Providers in Springfield, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.