Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Ivan Dominguez, MD

Individual provider Vascular Surgery Physician · NPI 1104070705

Dr. Ivan Dominguez, MD is a Vascular Surgery in San Juan, Puerto Rico. Graduated from Ponce School of Medicine in 2004, 22 years ago. Practices with Metro Santurce Inc, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York and Puerto Rico.

Years since qualifying
22
Trained at
Ponce School of Medicine
Licensed in
NY, PR
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address may be wrong

The ZIP code does not match the city and state on this record. Call before visiting.

1462 Calle Prof Augusto Rodriguez
San Juan, PR 00909-2199
Phone: (787) 727-6060

Additional practice locations (1)

  • 100 High St, Buffalo, NY 14203-1126 — (716) 859-3301

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence 021391 (PR)
Vascular Surgery Physician Taxonomy 2086S0129X · Licence 265300 (NY)

Record details

NPI number1104070705
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 10, 2008
Last updated in NPPESDecember 20, 2019
Certification dateDecember 20, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyVASCULAR SURGERY
Medical schoolPONCE SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Metro Santurce Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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