Jason Erek Domagalski, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

61149-20 Issued in WI

Practice address

555 E Tachevah Dr Ste 2E107
Palm Springs, CA 92262-5752

Phone

(760) 561-7373

Fax

(760) 770-5893

NPI assigned

Feb 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Family Medicine

  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• First Choice Physician Partners

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1912264862

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1972647170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E TACHEVAH DR STE 2E107",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625752",
            "telephone_number": "760-561-7373",
            "fax_number": "760-770-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E TACHEVAH DR STE 2E107",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625752",
            "telephone_number": "760-561-7373",
            "fax_number": "760-770-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAGALSKI",
        "first_name": "JASON",
        "middle_name": "EREK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "24005",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C129763",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "61149-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Diquattro, D.C.
• Divya RX Services
• Trinity Thienanh Khoa DO, PHARMD, MBA
• Kelsey Marie Dobes, CRNA
• Paul William Doherty, M.D.
• Genesis Sophia Dominguez
• Jasmine M Dominguez, LVN
• Don R. Scott MD. a Medical Corporation
• Megan Donnelly
• Alyssa Doty

• Family Medicine Physician in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.