MARIAH PAZ DOMINGUEZ PA-C
NPI 1235606518
Family Medicine in Grand Rapids, MI

NPI Status: Active since October 25, 2018

Contact Information

770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 272-3533
Fax: (616) 259-4839

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  • Individual
  • Female
  • Years of Experience 8
  • Family Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MARIAH DOMINGUEZ

This page provides the complete NPI Profile along with additional information for Mariah Dominguez, a primary care provider established in Grand Rapids, Michigan with a medical specialization in Family Medicine and more than 8 years of experience. The healthcare provider is registered in the NPI registry with number 1235606518 assigned on October 2018. The practitioner's primary taxonomy code is 207Q00000X with license number 9111654 (FL). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1235606518
Provider Name
MARIAH PAZ DOMINGUEZ PA-C
Gender
Female
Entity Type
Individual
Location Address
770 KENMOOR AVE SE STE 100 GRAND RAPIDS, MI 49546
Location Phone
(616) 272-3533
Location Fax
(616) 259-4839
Mailing Address
103 S JACKSON ST STE 200 JACKSON, MI 49201
Mailing Phone
(517) 212-9000
Medical School Name
OTHER
Graduation Year
2018
Is Sole Proprietor?
No
Enumeration Date
10-25-2018
Last Update Date
06-07-2022
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A primary care provider (PCP) like Mariah Dominguez sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
9111654
License State
FL
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Deluxe + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Deluxe + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
  • Connect Bronze 0 Indiv Med Deductible - EPO
  • Connect Bronze 5500 Indiv Med Deductible - EPO
  • Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
  • Connect Bronze CMS Standard - EPO
  • Connect Gold 2000 Indiv Med Deductible - EPO
  • Connect Gold 800 Indiv Med Deductible - EPO
  • Connect Gold CMS Standard - EPO
  • Connect Silver 3600 Indiv Med Deductible - EPO
  • Connect Silver 4300 Indiv Med Deductible - EPO
  • Connect Silver CMS Standard - EPO
  • Bronze First - HMO
  • Bronze First Adult Vision & Fitness - HMO
  • Diabetes Gold - HMO
  • Diabetes Gold Adult Vision & Fitness - HMO
  • Diabetes Silver - HMO
  • Diabetes Silver Adult Vision & Fitness - HMO
  • Gold - HMO
  • Gold Adult Vision & Fitness - HMO
  • HDHP Preventive Silver - HMO
  • Healthy Heart Gold - HMO
  • Healthy Heart Gold Adult Vision & Fitness - HMO
  • Healthy Heart Silver - HMO
  • Healthy Heart Silver Adult Vision & Fitness - HMO
  • Low Premium Silver - HMO
  • Low Premium Silver Adult Vision & Fitness - HMO
  • Silver - HMO
  • Silver Adult Vision & Fitness - HMO
  • Bronze 4 - HMO
  • Bronze 8 - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO
  • Silver 9 - HMO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Gold Elite Saver Plus - EPO
  • Secure - EPO
  • Silver Classic Standard - EPO
  • Silver Elite - EPO
  • Silver Simple Chronic Care CKM - EPO
  • Silver Simple Diabetes - EPO
  • Silver Simple PCP Saver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Mariah Dominguez is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Mariah Dominguez is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7214274422

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20240318002534

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 20 times for 20 patients

Assessment of and care planning for impaired thought processing, typically 50 minutes

This service involves a thorough evaluation of your thought processes, which may be impacting your daily life. In a typical 50-minute session, a healthcare professional will assess your cognitive abilities, identify any areas of concern, and develop a personalized care plan to help improve your mental function.

This service was performed 17 times for 16 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

This service was performed 12 times for 12 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

This service was performed 66 times for 32 patients

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month

Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.

This service was performed 68 times for 21 patients

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month

Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.

This service was performed 54 times for 28 patients

Established patient custodial care facility, group care, or assisted living visit, typically 1 hour

This service involves a healthcare professional visiting an established patient in a group care facility or assisted living for about an hour. The visit may include health checks, medication management, and addressing any health concerns to maintain the patient's well-being.

This service was performed 53 times for 23 patients

Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes

This is a routine visit for established patients residing in care facilities like nursing homes or assisted living. The visit typically lasts about 40 minutes, during which the healthcare provider checks your overall health, discusses any concerns, and adjusts care plans as needed.

This service was performed 215 times for 57 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.18 for a new patient copayment and $24.11 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 49546 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.74
  • Minimum New Patient Price $54.34
  • Maximum New Patient Price $166.68
  • Average New Patient Copayment $21.18
  • Minimum New Patient Copayment $13.58
  • Maximum New Patient Copayment $41.67

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $96.44
  • Minimum Established Patient Price $17.09
  • Maximum Established Patient Price $135.4
  • Average Established Patient Copayment $24.11
  • Minimum Established Patient Copayment $4.27
  • Maximum Established Patient Copayment $33.85

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1235606518
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22651201252
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 6 + 5 + 1 + 2 + 0 + 1 + 2 + 5 + 2 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1235606518 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1104429851 BRITTANY J DEVRIES AGNP
Individual
Nurse Practitioner (Adult Health)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1164731535MR. JEREMY RICHARD HERR MS, FNP, APNP
Individual
Nurse Practitioner (Family)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1275682437MRS. SHELLIANN MARIE ENDLINE NP
Individual
Nurse Practitioner770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1295482743 ANGELA COPLIN NP
Individual
Nurse Practitioner (Adult Health)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1922476373 ELIZABETH TAYLOR
Individual
Nurse Practitioner (Family)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1831889914MS. SARA ELIZABETH FRAGALE FNP
Individual
Nurse Practitioner770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1881305936MRS. MARION SATTA-GABLE SARJO
Individual
Nurse Practitioner (Family)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1508891995DR. SUZANNE MARIE HOWARD MD
Individual
Internal Medicine770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1770257818CARELINE HMI300 LLC
Organization
Hospice Care, Community Based770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(517) 212-2006
1801888938DR. MARY C BALL M.D.
Individual
Family Medicine (Geriatric Medicine)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1770283988 MASON JON WITTE NP
Individual
Nurse Practitioner770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1215799176 HEATHER JEAN WALKER AGNP-C
Individual
Nurse Practitioner770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1679089759MRS. REBECCA K BAKER MARRIOTT RN, MSN, FNP-BC
Individual
Nurse Practitioner (Family)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1114522471 ERIN KUCHAREK A-GNP-C
Individual
Nurse Practitioner (Primary Care)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(517) 212-2008
1578195681 CHELSEA DELISLE FNP- BC
Individual
Nurse Practitioner770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1942815238MRS. KATHLEEN THORN FNP-BC
Individual
Nurse Practitioner (Family)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1326544230 KAITLYN TROUTMAN COLLINS AGNP
Individual
Nurse Practitioner (Adult Health)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1396311510 GRANT OOSSE
Individual
Nurse Practitioner (Family)770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1154322113 WILLIAM H DUKES MD
Individual
Family Medicine770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533
1912515586 REBECCA JO NIELSEN NP
Individual
Nurse Practitioner770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
(616) 272-3533

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235606518, enumerated in the NPI registry as an "individual" on October 25, 2018

The provider is located at 770 Kenmoor Ave Se Ste 100 Grand Rapids, Mi 49546 and the phone number is (616) 272-3533

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 8 years of experience.

The provider might be accepting Accepts: AmeriHealth Caritas Next, Cigna Healthcare, HAP. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $84.74 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $96.44 and an average copayment of 24.11. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Assessment of and care planning for impaired thought processing, typically 50 minutes, Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month, Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month, Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month, Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month, Established patient custodial care facility, group care, or assisted living visit, typically 1 hour and Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes.

This NPI record was last updated on October 25, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.