Jason Roland Dominguez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04351 Issued in TX

Practice address

315 E 5TH St
Odessa, TX 79761-5133

Phone

(432) 333-3433

NPI assigned

May 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.8 of 100Reported as group

Promoting interoperability

88

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jdominguez@pinnacleskin.emadirect.md
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jasdominguez@conger.emadirect.md

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.

• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  TX

  Medicare reassignment
• Dermatology Associates

  • Dermatology Physician
  • Houston, TX
  • NPI 1356523039
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861608424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6213 GLENHAVEN DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625022",
            "telephone_number": "432-362-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615133",
            "telephone_number": "432-333-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JASON",
        "middle_name": "ROLAND",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yiling Ding, M.D.
• Divine Care Home Services, LLC
• Bryn Dodd, LPC
• William H Dodson, PT, DSC, OCS, CHT
• Brianna Dominguez
• Donald D Davenport Jr D O P a
• Dorado RX Pharmacy,LLC
• John H Doran, M.D.
• Daniel Paul Dorethy, LPC,LCDC,,MAC,M.ED.
• Jacquelynn Dorman, FNP

• Physician Assistant in Odessa, TX
• Providers in Odessa, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.