THOMAS JOSEPH DOMINGUEZ NPI 1568945004

NPI Information

NPI: 1568945004
Provider Name: THOMAS JOSEPH DOMINGUEZ
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS LLC

PECOS Registration: Yes

Address:
2401 FRIST BLVD STE 5
FORT PIERCE, FL
ZIP 34950
Phone: (772) 465-8100
Get Directions

Thomas Joseph Dominguez is a surgical physician assistant in Fort Pierce, FL with 6 years of experience. Thomas Joseph Dominguez NPI is 1568945004. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2401 FRIST BLVD STE 5
FORT PIERCE, FL
ZIP 34950-800
Phone: (772) 465-8100
Fax: (772) 465-8689

The NPI 1568945004 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/11/2018 and was last updated on 10/25/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207PE0004X	Emergency Medicine	Emergency Medical Services	4269	CONNECTICUT	No
2	207PP0204X	Emergency Medicine	Pediatric Emergency Medicine	4269	CONNECTICUT	No
3	207Q00000X	Family Medicine		4269	CONNECTICUT	No
4	207R00000X	Internal Medicine		4269	CONNECTICUT	No
5	363A00000X	Physician Assistant		4269	CONNECTICUT	No
6	363AM0700X	Physician Assistant	Medical	4269	CONNECTICUT	No
7	363AS0400X	Physician Assistant	Surgical	4269	CONNECTICUT	Yes
8	363A00000X	Physician Assistant		PA9113032	FLORIDA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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