| Mrs Jessica E Paonessa, MD | |
|
1221 Sixth St Ste 100, Traverse City, MI 49684 | |
| (231) 935-0322 | |
| (231) 935-0334 |
| Full Name | Mrs Jessica E Paonessa |
|---|---|
| Gender | Female |
| Speciality | Urology |
| Experience | 18 Years |
| Location | 1221 Sixth St Ste 100, Traverse City, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386760122 | NPI | - | NPPES |
| 03884526 | Medicaid | NY | |
| 201112070 | Medicaid | IN | |
| 000000792827 | Other | IN | ANTHEM PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 274692 (New York) | Secondary |
| 208800000X | Urology | 01071233A (Indiana) | Secondary |
| 208800000X | Urology | 4301113807 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Munson Medical Center | Traverse city, MI | Hospital |
| Munson Healthcare Cadillac Hospital | Cadillac, MI | Hospital |
| Paul Oliver Memorial Hospital | Frankfort, MI | Hospital |
| Munson Healthcare Otsego Memorial Hospital | Gaylord, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Munson Medical Center | 3072426287 | 345 |
| Entity Name | Munson Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083761860 PECOS PAC ID: 3072426287 Enrollment ID: O20040108000904 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Jessica E Paonessa, MD 1221 Sixth St Ste 100, Traverse City, MI 49684-2359 Ph: (231) 935-0322 | Mrs Jessica E Paonessa, MD 1221 Sixth St Ste 100, Traverse City, MI 49684 Ph: (231) 935-0322 |
Dr. Ward Robert Gillett, M.D. Urology Medicare: Medicare Enrolled Practice Location: 3922 Cedar Run Rd, Traverse City, MI 49684 Phone: 231-935-0322 Fax: 231-935-0334 | |
Dr. Andrew Charles Luea, D.O. Urology Medicare: Accepting Medicare Assignments Practice Location: 3922 Cedar Run Rd, Traverse City, MI 49684 Phone: 231-935-0322 | |
Michael Harris, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 4100 Park Forest Dr Ste 200, Traverse City, MI 49684 Phone: 231-600-7466 Fax: 877-370-4631 | |
Diane Begg Young, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 3922 Cedar Run Rd, Traverse City, MI 49684 Phone: 231-935-0322 Fax: 231-935-0334 | |
Dr. Wayne Kenneth Stefanciw, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 3922 Cedar Run Rd, Traverse City, MI 49684 Phone: 231-935-0322 Fax: 231-935-0334 | |
Dr. Robert Michael Hall, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 3922 Cedar Run Rd, Traverse City, MI 49684 Phone: 231-935-0322 Fax: 231-935-0334 |