Active NPI
Samantha Teresa Dominguez, MD
- Student in an Organized Health Care Education/Training Program
- Kalamazoo, MI
National Provider Identifier
1891583225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 4351054685
- Practice address
- 1000 Oakland Dr
Kalamazoo, MI 49008-1282 - Phone
- (269) 337-4600
- NPI assigned
- Apr 26, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4351054685 | MI | Primary |
Addresses
Primary practice location
1000 Oakland Dr
Kalamazoo, MI 49008-1282
Mailing address
1000 Oakland Dr
Kalamazoo, MI 49008-1282
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250626001020 | MI | Order and Referring Only - Orthopedic Surgery | 0244742948 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351054685 | MI | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750291200000",
"number": "1891583225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 OAKLAND DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490081282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 OAKLAND DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490081282",
"telephone_number": "269-337-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "SAMANTHA",
"middle_name": "TERESA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-26",
"last_updated": "2025-06-19",
"certification_date": "2025-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4351054685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.