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CARL MATTHEW PESTA D.O.
NPI 1114983913
Surgery in Mount Clemens, MI

Active since April 21, 2006PECOS EnrolledAccepts Medicare Assignment
1030 HARRINGTON ST, 302A, MOUNT CLEMENS, MI 48043(586) 759-2005(586) 759-2636 Get Directions Write a Review

NPPES record last updated: May 26, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1114983913
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameCARL MATTHEW PESTACredential: D.O.
Location Address1030 HARRINGTON ST, 302AMount Clemens, MI 48043-2967
Mailing Address1030 Harrington St, Suite 302aMount Clemens, MI 48043-2967 · (586) 759-2005 · Fax (586) 759-2636
Phone(586) 759-2005
Fax(586) 759-2636
Sole ProprietorNo
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 1996
Enumeration DateApril 21, 2006
Last NPPES UpdateMay 26, 2015
✔ NPI 1114983913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MI · 5101013083
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
1030 HARRINGTON ST, Mount Clemens, MI 48043
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Other Identifiers 4

Other0255003665MI · Bcbs Pin
Medicare UPINH44628MI
Medicare PIN0N76210003MI
Medicaid114446930MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID5890714661
PECOS Enrollment IDI20051122000427
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
112 services48 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
47 services31 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
33 services33 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
23 services15 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
22 services21 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients

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, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230216
Location1221 Pine Grove AvePort Huron, MI 48060 · St. Clair County
Emergency services Birthing friendly

Mclaren Macomb

Acute Care Hospitals · Mount Clemens, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230227
Location1000 Harrington StMount Clemens, MI 48043 · Macomb County
Emergency services Birthing friendly

Physician 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.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

CARMEN EPSTEIN R.D., C.D.E.
Dietitian, Registered
1030 HARRINGTON ST, SUITE 202
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-3396
DR. ASHLEY N HARNDEN D.O.
Surgery
1030 HARRINGTON ST, SUITE 103
MOUNT CLEMENS, MI 48043
Macomb County (586) 466-6230
JOHN FLORIAN KAZMIERSKI DO
Internal Medicine (Cardiovascular Disease)
1030 HARRINGTON ST, SUITE 101
MOUNT CLEMENS, MI 48043
Macomb County (586) 468-8500
CAROL M FISCHER DO PLLC
Clinic/Center (Medical Specialty)
1030 HARRINGTON ST, SUITE 201
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-3880
CAROL MARIAM FISCHER D.O.
Obstetrics & Gynecology
1030 HARRINGTON ST, SUITE 201
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-3880
DR. STEPHEN DOUGLAS CAHILL D.O.
Surgery
1030 HARRINGTON ST, SUITE 103
MOUNT CLEMENS, MI 48043
Macomb County (586) 466-6230
DR. JULIE ANNE-MARIE BURNHAM D.O.
Psychiatry & Neurology (Neurology)
1030 HARRINGTON ST
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-3188
COMMUNITY CANCER CARE SPECIALISTS
Non-Pharmacy Dispensing Site
1030 HARRINGTON ST, STE 301
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-3440

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.

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.