Individual provider Active NPI

Domingo G Aviado, MD

  • Family Medicine Physician
  • Brick, NJ
National Provider Identifier
1891718185
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA10191700 Issued in NJ
Practice address
250 Chambers Bridge Road
Brick, NJ 08723
Phone
(732) 771-2222
Fax
(732) 771-2223
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C10004793 DE
Family Medicine Physician 207Q00000X 25MA10191700 NJ Primary

Addresses

Primary practice location

250 Chambers Bridge Road
Brick, NJ 08723

Mailing address

250 Chambers Bridge Road
Brick, NJ 08723
Phone (732) 771-2222

Other identifiers 1

IdentifierTypeStateIssuer
000719701MedicaidDE

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C10004793DEMDFamily Medicine Physician
25MA10191700NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frdocs LLC Family Medicine PastSince Jul 12, 2020 Accepting new patients
Delaware Podiatric Medicine PA PastSince Jul 1, 2004 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: domingo.aviado@593314999828484.direct.elationemr.com

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1891718185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CHAMBERS BRIDGE ROAD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08723",
            "telephone_number": "732-771-2222",
            "fax_number": "732-771-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHAMBERS BRIDGE ROAD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08723",
            "telephone_number": "732-771-2222",
            "fax_number": "732-771-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVIADO",
        "first_name": "DOMINGO",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C10004793",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10191700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000719701",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.