Individual provider Active NPI

William Dominic, MD

  • Trauma Surgery Physician
  • Fresno, CA
National Provider Identifier
1942310891
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
G60346 Issued in CA
Practice address
2823 Fresno St
Fresno, CA 93721-1324
Phone
(559) 459-3770
NPI assigned
Aug 30, 2006
Last updated
Jan 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X G60346 CA
Surgery Physician 208600000X G60346 CA
Trauma Surgery Physician 2086S0127X G60346 CA Primary

Addresses

Primary practice location

2823 Fresno St
Fresno, CA 93721-1324

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000573 CA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 4183785454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as group
Quality
76.71
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G60346CAMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Faculty Associates, Inc. CurrentSince Apr 1, 2015 Accepting new patients
Central California Faculty Medical Group, Inc. Current Accepting new patients
University Faculty Associates , Inc. CurrentSince Apr 1, 2015 Accepting new patients
University Faculty Associates, Inc. Past Accepting new patients

Locations

1303 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-3000

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

2335 E Kashian Ln
Ste 410
Fresno, CA 93701
Phone (559) 266-4100

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

3837 N Clark St
Fresno, CA 93726
Phone (559) 243-3604

445 S Cedar Ave
Fresno, CA 93702
Phone (559) 459-4000

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1942310891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-459-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIC",
        "first_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "G60346",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G60346",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "G60346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.