DOMINIQUE MACK PA-C
NPI 1992575617
Physician Assistant in Thomasville, GA

Q: What is Dominique Mack's NPI number?

The NPI number for Dominique Mack is 1992575617. It was assigned to this individual provider in the NPPES registry on January 3, 2024. The provider is also known as Nique Mack Pa-C.

Q: What is Dominique Mack's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Dominique Mack was last updated on May 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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 January 03, 2024PECOS EnrolledAccepts Medicare Assignment

334 SMITH AVE, THOMASVILLE, GA 31792(229) 227-1595 Get Directions Write a Review

NPPES record last updated: May 8, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 8, 2026, Jan 3, 2024 (2 updates tracked since 2024).

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About Dominique Mack Pa-c NPPES

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

DOMINIQUE MACK PA-C (NPI 1992575617) is an individual physician assistant in Thomasville, Georgia, licensed in Georgia (13682) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS, is affiliated with Archbold Memorial, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1992575617

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameDOMINIQUE MACKCredential: PA-C

Location Address334 SMITH AVEThomasville, GA 31792-5533

Mailing Address334 Smith AveThomasville, GA 31792-5533 · (229) 227-1595 · Fax (229) 227-1385

Phone(229) 227-1595

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJanuary 3, 2024

Last NPPES UpdateMay 8, 20262 updates tracked since enumeration

NPPES CertifiedMay 8, 2026

✔ NPI 1992575617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in GA · 13682

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

334 SMITH AVE, Thomasville, GA 31792

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Other Names 1

Other Name (5)Nique Mack Pa-c

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dominique Mack Pa-c 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 ID345722468

PECOS Enrollment IDI20260306001010

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.

Hospital Affiliations CMS Care Compare

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

Archbold Memorial

Acute Care Hospitals · Thomasville, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110038

Location915 Gordon Avenue & Mimosa DriveThomasville, GA 31792 · Thomas County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31792 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

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

MR. WILLIAM B HOOKS PA-C

Physician Assistant (Medical)