Individual provider Active NPI

Dominique L Sanchez, M.D.

  • Family Medicine Physician
  • Decatur, IN
National Provider Identifier
1972036093
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2020-0249 Issued in NM
Practice address
1100 Mercer Ave
Decatur, IN 46733-2303
Phone
(260) 724-2145
NPI assigned
Apr 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2020-0249 NM Primary

Addresses

Primary practice location

1100 Mercer Ave
Decatur, IN 46733-2303

Mailing address

PO Box 151
Decatur, IN 46733-0151
Phone (260) 724-2145

Other practice location 1

11 Melnea Cass Blvd
Boston, MA 02119-4401
Phone (617) 414-2080

Other practice location 2

850 Harrison Ave, FL 4
Yawkey Bldg
Boston, MA 02118
Phone (617) 414-2000

Other identifiers 3

IdentifierTypeStateIssuer
110185341AMedicaidMA
300083719MedicaidIN
3138553MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240117001512 IN Practitioner - Family Practice 8123397205 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adams County Memorial Hospital CurrentSince Dec 1, 2023 Accepting new patients
Adams County Memorial Hospital CurrentSince Dec 1, 2023 Accepting new patients

Locations

1100 Mercer Ave
Decatur, IN 46733

Interoperability endpoints

  • Direct secure messaging: dsanchez588754@direct.parkviewexchange.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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1972036093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467330151",
            "telephone_number": "260-724-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MERCER AVE",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332303",
            "telephone_number": "260-724-2145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Melnea Cass Blvd",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021194401",
            "country_code": "US",
            "telephone_number": "617-414-2080",
            "fax_number": "617-414-2090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Harrison Ave, FL 4",
            "address_2": "Yawkey Bldg",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "DOMINIQUE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2020-0249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110185341A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300083719",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3138553",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IN

Sources for this page

Verify at the official NPI Registry.