Jason Glenn Domina, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036159775 Issued in IL

Practice address

4201 W Medical Center Dr
McHenry, IL 60050-8409

Phone

(815) 334-5566

Fax

(815) 759-4008

NPI assigned

Jul 12, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, WV, KY, IL4 enrollments

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 4

Specialty

Diagnostic Radiology

Education

Wayne State University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Barbara Ann Karmanos Cancer InstituteGroup PAC ID 3870407901, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
• McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105
• McLaren Bay Region Hospital, Bay City, MI, CCN 230041
• McLaren Central Michigan Hospital, Mount Pleasant, MI, CCN 230080

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdomina@direct.dmc.org

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.

• Baptist Health Medical Group Inc

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1518360296
  Medicare reassignment Care Compare group NPD
• Barbara Ann Karmanos Cancer Institute

  • Mammography Clinic/Center
  • Detroit, MI
  • NPI 1225022288
  Medicare reassignment Care Compare group NPD
• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066
  Medicare reassignment Care Compare group NPD
• Appalachian Mountains Medical, LLC

  • Emergency Medicine Physician
  • Welch, WV
  • NPI 1881023117

  Diagnostic Radiology

  Medicare reassignment NPD
• Garden City Radiology PLLC

  • Diagnostic Radiology Physician
  • Garden City, MI
  • NPI 1336612084
  Medicare reassignment NPD
• Sheridan Community Hospital

  • Emergency Medicine Physician
  • Sheridan, MI
  • NPI 1528090594
  Medicare reassignment NPD (past)
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD
• Barbara Ann Karmanos Cancer Institute

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Detroit, MI
  • NPI 1386060226
  NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD
• Princeton Community Hospital Assn Inc.

  • Urology Physician
  • Princeton, WV
  • NPI 1093917643
  NPD
• Princeton Community Hospital Assn., Inc

  • Rural Health Clinic/Center
  • Bluefield, VA
  • NPI 1235446485
  NPD

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

• Barbara Ann Karmanos Cancer Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1316900277
  Care Compare affiliation
• McLaren Bay Region

  • General Acute Care Hospital
  • Bay City, MI
  • NPI 1528031226
  Care Compare affiliation
• McLaren Central Michigan

  • Rural Acute Care Hospital
  • Mt Pleasant, MI
  • NPI 1619941317
  Care Compare affiliation
• McLaren Northern Michigan

  • Psychiatric Hospital Unit
  • Cheboygan, MI
  • NPI 1336897735
  Care Compare affiliation
• McLaren Northern Michigan

  • General Acute Care Hospital
  • Petoskey, MI
  • NPI 1992812580
  Care Compare affiliation

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

{
    "created_epoch": "1247356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1952530974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-334-5566",
            "fax_number": "815-759-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-334-5566",
            "fax_number": "815-759-4008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Dr",
            "address_2": "B1 floor University Hospital Recp C",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095030",
            "country_code": "US",
            "telephone_number": "734-936-4566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINA",
        "first_name": "JASON",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-12",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301094862",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036159775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darian Rose Dobrolinsky
• Barbara E. Dolan, LCPC
• Kylie E Domann
• Ciera Rose Dombeck
• Ashley Elizabeth Domin, MSW
• Alicia Magdalena Dominguez
• Anne Donald
• Phillip Donald
• Kelly Lynn Donohue, MD
• Sarah Donohue

• Diagnostic Radiology Physician in McHenry, IL
• Providers in McHenry, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.