NPIMap

Individual provider Active NPI

Marina Domatova, MD

  • Emergency Medicine Physician
  • Macungie, PA
National Provider Identifier
1235369265
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD486114 Issued in PA
Practice address
3369 Route 100
Macungie, PA 18062-9613
Phone
(610) 402-8111
NPI assigned
Jul 24, 2009
Last updated
Jan 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 012873 NY
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X MD486114 PA Primary
Emergency Medicine Physician 207P00000X 32484 WV

Addresses

Primary practice location

3369 Route 100
Macungie, PA 18062-9613

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622

Other identifiers 3

IdentifierTypeStateIssuer
32484OtherWVLICENSE
D0095827OtherMDLICENSE
012873OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240920001401 PA Practitioner - Emergency Medicine 6305269606 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Emergency Physician Associates of Pennsylvania PCGroup PAC ID 5597663252, 88 clinicians

Practice addresses (Care Compare)

3369 State Route 100
LVPG Emergency Medicine Macungie
Macungie, PA 18062
Phone (610) 402-8111

700 E Norwegian St
Pottsville, PA 17901-2710
Phone (570) 621-4090

746 Jefferson Ave
Scranton, PA 18510-1624
Phone (570) 348-7100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
74.59
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32484WVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Physician Services, LLC Emergency Medicine CurrentSince Aug 10, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 20, 2026 Accepting new patients
Pennsylvania Physician Services, LLC Emergency Medicine Current Accepting new patients
Emergency Physician Associates of Pennsylvania, PC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 20, 2026 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

2100 Mack Blvd
Fl 4
Allentown, PA 18103

300 Highland Ave
Hanover, PA 17331
Phone (717) 316-3711

3369 Route 100
Macungie, PA 18062
Phone (484) 232-6863

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

334 Main St
Scranton, PA 18519
Phone (570) 307-1767

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

Interoperability endpoints

  • Direct secure messaging: mdomatova448384@direct.wvuhsdirect.com

Organizations & group practices 7

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1235369265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3369 ROUTE 100",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180629613",
            "telephone_number": "610-402-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMATOVA",
        "first_name": "MARINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "012873",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD486114",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "32484",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "32484",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D0095827",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "012873",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macungie, PA

Sources for this page

Verify at the official NPI Registry.