DALLAS LEE DOMANGUE MD
NPI 1205413010
Anesthesiology in Jackson, MS

Q: What is Dallas Domangue's NPI number?

The NPI number for Dallas Domangue is 1205413010. It was assigned to this individual provider in the NPPES registry on March 26, 2021.

Q: What is Dallas Domangue's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Q: When was this NPI record last updated?

The NPPES record for Dallas Domangue was last updated on July 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 26, 2021PECOS EnrolledAccepts Medicare Assignment

2500 N STATE ST, JACKSON, MS 39216(601) 984-1000 Get Directions Write a Review

NPPES record last updated: July 3, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 3, 2021, Mar 26, 2021 (2 updates tracked since 2021).

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About Dallas Lee Domangue Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DALLAS LEE DOMANGUE MD (NPI 1205413010) is an individual anesthesiology provider in Jackson, Mississippi, licensed in Mississippi (T-4248) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS, is affiliated with Thibodaux Regional Medical Center, and is a graduate of Louisiana State University School Of Medicine In New Orleans (2021).

NPPES Registry Identity

NPI1205413010

Entity TypeIndividualMale

Primary Taxonomy207L00000X

Provider Legal NameDALLAS LEE DOMANGUECredential: MD

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address127 Parkway Dr Apt 1103Jackson, MS 39211-4212 · (985) 860-6961

Phone(601) 984-1000

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2021

Enumeration DateMarch 26, 2021

Last NPPES UpdateJuly 3, 20212 updates tracked since enumeration

NPPES CertifiedJuly 3, 2021

✔ NPI 1205413010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians

Taxonomy Code207L00000X

License✔ Licensed in MS · T-4248

Definition

An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2500 N STATE ST, Jackson, MS 39216

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMO Louisiana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dallas Lee Domangue Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911305511

PECOS Enrollment IDI20250904001508

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Dallas Domangue reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Zephyr Anesthesia, LLC

155 mi

Anesthesiology

694 BELLE TERRE BLVD
La Place, LA 70068

Reassigned Medicare billing, Louisiana enrollment
482 clinicians in this Medicare group

NPI 1891087458 (504) 813-3101

Thibodaux Regional Network Development Corporation

166 mi

Cardiovascular Disease

22080 LA HWY 20
Vacherie, LA 70090

Reassigned Medicare billing, Louisiana enrollment
179 clinicians in this Medicare group

NPI 1720853435 (985) 493-4993

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Thibodaux Regional Medical Center

Acute Care Hospitals · Thibodaux, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190004

Location602 N Acadia RoadThibodaux, LA 70301 · Lafourche County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAMAR DAVIS II M.D.

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)