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

Mariah Paz Dominguez, PA-C

Individual provider Family Medicine Physician · NPI 1235606518

Mariah Paz Dominguez, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2018, 8 years ago. Practices with Vitalmd Group Holding LLC, a 532-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
8
Licensed in
FL
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

770 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-8602
Phone: (616) 272-3533
Fax: (616) 259-4839
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 9111654 (FL)

Record details

NPI number1235606518
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 25, 2018
Last updated in NPPESJune 7, 2022
Certification dateApril 8, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Vitalmd Group Holding Llc — 532 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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