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SHELBY PEDIATRIC ASSOCIATES AND CHILD LUNG CENTER PC
NPI 1124051990
Pediatrics in Shelby Township, MI

Active since July 07, 2006CLIA 23D2284815 · Waiver
15125 22 MILE RD, SHELBY TOWNSHIP, MI 48315(586) 532-0599(586) 566-8967 Get Directions Write a Review

NPPES record last updated: March 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shelby Pediatric Associates And Child Lung Center Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELBY PEDIATRIC ASSOCIATES AND CHILD LUNG CENTER PC (NPI 1124051990) is a healthcare organization registered as a pediatrics in Shelby Township, Michigan and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through June 28, 2027 and lists Maria Pellerito, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1124051990
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSHELBY PEDIATRIC ASSOCIATES AND CHILD LUNG CENTER PC
Location Address15125 22 MILE RDShelby Township, MI 48315-4406
Mailing Address15125 22 Mile RdShelby Township, MI 48315-4406 · (586) 532-0599 · Fax (586) 566-8967
Phone(586) 532-0599
Fax(586) 566-8967
Organization SubpartNo
Authorized OfficialMaria PelleritoOffice Manager · (586) 532-0599
Enumeration DateJuly 7, 2006
Last NPPES UpdateMarch 27, 2024
NPPES CertifiedMarch 27, 2024
✔ NPI 1124051990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · AR2460549
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
15125 22 MILE RD, Shelby Township, MI 48315
Open in Google Maps ↗

Other Identifiers 3

Medicaid4669589MI
Medicaid4432864MI
Medicaid4432882MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2284815

Shelby Pediatric Associates · Lenox, MI
Active · expires Jun 28, 2027
CLIA Number23D2284815
Laboratory TypePhysician Office
Certificate Effective DateJune 29, 2025
Certificate Expiration DateJune 28, 2027
Laboratory DirectorSalvatore Ventimiglia
Laboratory Phone(586) 532-0599
Laboratory LocationShelby Pediatric Associates36555 26 Mile Road Suite 2100, Lenox, MI 48048
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D0036052

Shelby Pediatrics Associates And Child Living Cntr · Shelby Township, MI
Expired · Aug 3, 2026
CLIA Number23D0036052
Laboratory TypePhysician Office
Certificate Effective DateAugust 4, 2024
Certificate Expiration DateAugust 3, 2026
Laboratory DirectorSalvatore Ventimiglia
Laboratory Phone(586) 532-0599
Laboratory LocationShelby Pediatrics Associates And Child Living Cntr15125 22 Mile Road, Shelby Township, MI 48315
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS JOHN ZAHARI
Pediatrics
15125 22 MILE RD
SHELBY TOWNSHIP, MI 48315
Macomb County (586) 532-0599
KATHERINE JEAN VALMORES YULO M.D.
Pediatrics
15125 22 MILE RD
SHELBY TOWNSHIP, MI 48315
Macomb County (586) 532-0599
DR. GIDEON OKARI NYAKUNDI MD
Pediatrics
15125 22 MILE RD
SHELBY TOWNSHIP, MI 48315
Macomb County (586) 532-0599
JESSICA MARIE MCCARTHY C.R.N.P.
Nurse Practitioner (Pediatrics)
15125 22 MILE RD
SHELBY TWP, MI 48315
Macomb County (586) 532-0599
MRS. KELLY LYNN DOBRZENIECKI NP-C
Nurse Practitioner (Family)
15125 22 MILE RD
SHELBY TOWNSHIP, MI 48315
Macomb County (586) 532-0599
DR. LEONIDAS P MOSCHOURIS MD
Pediatrics
15125 22 MILE RD
SHELBY TOWNSHIP, MI 48315
Macomb County (586) 532-0599
PAULINA MULTHAUPT
Psychologist (Clinical)
15125 22 MILE RD
SHELBY TOWNSHIP, MI 48315
Macomb County (586) 532-0599
DR. SALVATORE VENTIMIGLIA MD
Pediatrics
15125 22 MILE RD
SHELBY TOWNSHIP, MI 48315
Macomb County (586) 532-0599

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 Shelby Pediatric Associates And Child Lung Center PC's NPI number?

The NPI number for Shelby Pediatric Associates And Child Lung Center PC is 1124051990. It was assigned to this organization in the NPPES registry on July 7, 2006.

Where is Shelby Pediatric Associates And Child Lung Center PC located?

Shelby Pediatric Associates And Child Lung Center PC is located at 15125 22 Mile Rd, Shelby Township, MI 48315. The listed phone number is (586) 532-0599.

What is Shelby Pediatric Associates And Child Lung Center PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Shelby Pediatric Associates And Child Lung Center PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2284815) is associated with this NPI, valid through June 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Shelby Pediatric Associates And Child Lung Center PC accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Shelby Pediatric Associates And Child Lung Center PC 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.

When was this NPI record last updated?

The NPPES record for Shelby Pediatric Associates And Child Lung Center PC was last updated on March 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.