Individual provider Active NPI

Domilyn Quina-Madraso

  • Physical Therapist
  • Waco, TX
National Provider Identifier
1740756303
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1073773 Issued in TX
Practice address
50 Hillcrest Medical Blvd Ste 102
Waco, TX 76712-8953
Phone
(254) 202-7900
NPI assigned
Oct 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1073773 TX Primary

Addresses

Primary practice location

50 Hillcrest Medical Blvd Ste 102
Waco, TX 76712-8953

Mailing address

PO Box 848491
Dallas, TX 75284-8491
Phone (254) 202-9330

Other practice location 1

208 N Main St Ste 130
Weatherford, TX 76086-3267
Phone (817) 662-7800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmadraso54252@direct.sw.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815001383 TX Practitioner - Physical Therapist in Private Practice 3870035074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillcrest Physician ServicesGroup PAC ID 1153304456, 114 clinicians

Practice addresses (Care Compare)

50 Hillcrest Medical Blvd
Waco, TX 76712-8952
Phone (254) 202-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Physician Services CurrentSince May 28, 2024 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

50 Hillcrest Medical Blvd
Ste 102
Waco, TX 76712
Phone (254) 202-7215

50 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-7300

Interoperability endpoints

  • Direct secure messaging: dmadraso54252@direct.sw.org

Organizations & group practices 2

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": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1740756303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848491",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848491",
            "telephone_number": "254-202-9330",
            "fax_number": "254-202-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 HILLCREST MEDICAL BLVD STE 102",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128953",
            "telephone_number": "254-202-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 N Main St Ste 130",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760863267",
            "country_code": "US",
            "telephone_number": "817-662-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINA-MADRASO",
        "first_name": "DOMILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1073773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmadraso54252@direct.sw.org",
            "affiliation": "N",
            "address_1": "50 Hillcrest Medical Blvd Ste 102",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.

Verify at the official NPI Registry.