Mairead Elizabeth Donovan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.009279RX Issued in OH

Practice address

7050 Spring MDWS Dr W
Holland, OH 43528-7203

Phone

(419) 948-3376

Fax

(419) 665-3632

NPI assigned

Dec 25, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Toledo College of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bravia Dermatology Group LLCGroup PAC ID 3678856671, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bravia Dermatology Group, LLC

  • Dermatology Physician
  • Holland, OH
  • NPI 1356884837
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1144099706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 SPRING MDWS DR W",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435287203",
            "telephone_number": "419-948-3376",
            "fax_number": "419-665-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 SPRING MDWS DR W",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435287203",
            "telephone_number": "419-948-3376",
            "fax_number": "419-665-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "MAIREAD",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-25",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009279RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ciara Latavia Dickerson
• Diterlizzi Dental, LLC
• Vy T DO, LISW-S
• Randall Ryan Domby
• Erich Donati, CDCA
• Clint Dorn
• Duane J. Kerscher Jr., D.O. D.B.a. Springfield Clinic L.L.C.
• Christy Duchene
• Arthur Dunson, CDCA
• Rosalinda Duran-McKellip, CDCA

• Physician Assistant in Holland, OH
• Providers in Holland, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.