Active NPI
Ian J Dominguez, DO
- Hospitalist Physician
- Troy, MI
National Provider Identifier
1952097065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 5101029481
- Practice address
- 44201 Dequindre Rd
Troy, MI 48085-1117 - Phone
- (248) 964-5000
- NPI assigned
- Apr 12, 2023
- Last updated
- Aug 12, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 5101029481 | MI | Primary |
Addresses
Primary practice location
44201 Dequindre Rd
Troy, MI 48085-1117
Mailing address
1827 Oakshire Ave
Berkley, MI 48072-1285
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 |
|---|---|---|---|---|
| I20230611000196 | MI | Order and Referring Only - Internal Medicine | 5092172700 |
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
12745 S Saginaw
Suite 196
Grand Blanc, MI 48439-2437
12745 S Saginaw St
806 196
Grand Blanc, MI 48439-2437
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health Macomb-Oakland Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Henry Ford Warren Hospital
- Social Worker
- Warren, MI
- NPI 1548609761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1952097065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1827 OAKSHIRE AVE",
"city": "BERKLEY",
"state": "MI",
"postal_code": "480721285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44201 DEQUINDRE RD",
"city": "TROY",
"state": "MI",
"postal_code": "480851117",
"telephone_number": "248-964-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "IAN",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-12",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MI",
"license": "5101029481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.