| Carl Matthew Pesta, DO | |
|
1030 Harrington St, 302a, Mount Clemens, MI 48043-2967 | |
| (586) 759-2005 | |
| (586) 759-2636 |
| Full Name | Carl Matthew Pesta |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 29 Years |
| Location | 1030 Harrington St, Mount Clemens, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114983913 | NPI | - | NPPES |
| 114446930 | Medicaid | MI | |
| 0255003665 | Other | MI | BCBS PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 5101013083 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mclaren Macomb | Mount clemens, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Regional Trauma Care Pc | 3173691771 | 10 |
| Surgical Consultants Pllc | 6800803917 | 3 |
| Entity Name | Mclaren Macomb |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396014601 PECOS PAC ID: 8921912791 Enrollment ID: O20040120001000 |
| Entity Name | Mclaren Port Huron |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386888170 PECOS PAC ID: 9931018702 Enrollment ID: O20040204000779 |
| Entity Name | Surgical Consultants Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891708814 PECOS PAC ID: 6800803917 Enrollment ID: O20060315000253 |
| Entity Name | Regional Trauma Care Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851554497 PECOS PAC ID: 3173691771 Enrollment ID: O20081009000458 |
| Mailing Address | Practice Location Address |
|---|---|
| Carl Matthew Pesta, DO 1030 Harrington St, Suite 302a, Mount Clemens, MI 48043-2967 Ph: (586) 759-2005 | Carl Matthew Pesta, DO 1030 Harrington St, 302a, Mount Clemens, MI 48043-2967 Ph: (586) 759-2005 |
Allyson Bowes Rivard, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1000 Harrington Blvd., Mount Clemens, MI 48043 Phone: 586-493-8000 | |
Mikaela Nicole Vitug, DO Surgery Medicare: Medicare Enrolled Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-790-9003 | |
Dr. Hannah Grace Jayroe, D.O. Surgery Medicare: Medicare Enrolled Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8000 | |
Dr. Ashley N Harnden, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1030 Harrington St, Suite 103, Mount Clemens, MI 48043 Phone: 586-466-6230 Fax: 586-496-3828 | |
Michael John Fish, DO Surgery Medicare: Medicare Enrolled Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8142 Fax: 586-493-3250 | |
Hannah Chong, DO Surgery Medicare: Not Enrolled in Medicare Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-790-9003 |