CARL MATTHEW PESTA D.O.
NPI 1114983913
Surgery in Mount Clemens, MI
About Carl Matthew Pesta D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CARL MATTHEW PESTA D.O. (NPI 1114983913) is an individual surgery provider in Mount Clemens, Michigan, licensed in Michigan (5101013083) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Mclaren Port Huron, and is a graduate of Michigan State University College Of Osteopathic Medicine (1996).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Carl Matthew Pesta D.o. 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.
Medicare Billing Reassignments
4Medicare enrollment records show Carl Pesta reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Mount Clemens, MI 48043
- Reassigned Medicare billing, Michigan enrollment
- 188 clinicians in this Medicare group
Mount Clemens, MI 48043
- Reassigned Medicare billing, Michigan enrollment
- 10 clinicians in this Medicare group
Mount Clemens, MI 48043
- Reassigned Medicare billing, Michigan enrollment
- 3 clinicians in this Medicare group
Port Huron, MI 48060
- Reassigned Medicare billing, Michigan enrollment
- 87 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mclaren Port Huron
Acute Care Hospitals · Port Huron, MIMclaren Macomb
Acute Care Hospitals · Mount Clemens, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48043 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Carl Pesta's NPI number?
The NPI number for Carl Pesta is 1114983913. It was assigned to this individual provider in the NPPES registry on April 21, 2006.
Where is Carl Pesta located?
Carl Pesta practices at 1030 Harrington St 302A, Mount Clemens, MI 48043. The listed phone number is (586) 759-2005.
What is Carl Pesta's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Carl Pesta enrolled in Medicare?
Yes. Carl Pesta is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Carl Pesta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Carl Pesta reassigns Medicare benefits to 4 organizations: Mclaren Macomb (Mount Clemens, MI), Regional Trauma Care PC (Mount Clemens, MI), Surgical Consultants PLLC (Mount Clemens, MI) and Mclaren Port Huron (Port Huron, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carl Pesta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Carl Pesta accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Carl Pesta as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Carl Pesta affiliated with any hospitals?
According to CMS data, Carl Pesta is affiliated with Mclaren Port Huron and Mclaren Macomb.
When was this NPI record last updated?
The NPPES record for Carl Pesta was last updated on May 26, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.
# Carl Matthew Pesta, D.O. · NPI 1114983913
Surgery physician in Mount Clemens, Michigan. Individual provider, active in the CMS NPPES registry since April 21, 2006.
## Identity
- **NPI:** 1114983913 (Entity type: Individual)
- **Enumerated:** April 21, 2006
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 5101013083 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 1030 HARRINGTON ST, 302A, Mount Clemens, MI 48043-2967
- **Phone:** (586) 759-2005 · **Fax:** (586) 759-2636
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Mclaren Macomb (NPI 1396014601, Mount Clemens, MI); Regional Trauma Care PC (NPI 1851554497, Mount Clemens, MI); Surgical Consultants PLLC (NPI 1891708814, Mount Clemens, MI); Mclaren Port Huron (NPI 1386888170, Port Huron, MI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Michigan State University College Of Osteopathic Medicine, class of 1996
## Record status
- **NPPES last updated:** May 26, 2015
- **Other identifiers:** Other 0255003665 (MI); Medicare UPIN H44628 (MI); Medicare PIN 0N76210003 (MI); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1114983913) · Data from the CMS NPPES public registry.