Active NPI
Jamielu Ureta Dominguez, DPT
- Physical Therapist
- Honolulu, HI
National Provider Identifier
1861040008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-4889
- Practice address
- 960 Prospect St Apt 8
Honolulu, HI 96822-3438 - Phone
- (808) 979-5705
- NPI assigned
- Aug 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-4889 | HI | Primary |
Addresses
Primary practice location
960 Prospect St Apt 8
Honolulu, HI 96822-3438
Mailing address
1401 S Beretania St Ste 550
Honolulu, HI 96814-1880
Phone (808) 381-8947
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3213 | Other | HI | UNIVERSITY HEALTH ALLIANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1861040008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 S BERETANIA ST STE 550",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968141880",
"telephone_number": "808-381-8947",
"fax_number": "808-591-2245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "960 PROSPECT ST APT 8",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968223438",
"telephone_number": "808-979-5705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "JAMIELU",
"middle_name": "URETA",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-30",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "HI",
"license": "PT-4889",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERSITY HEALTH ALLIANCE",
"identifier": "3213",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.