NPIMap

Individual provider Active NPI

Paul Dominic Paonessa, MD

  • Family Medicine Physician
  • Chesterfield, MI
National Provider Identifier
1093985145
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301086103 Issued in MI
Practice address
34301 23 Mile Rd
Suite 100
Chesterfield, MI 48047-4432
Phone
(586) 725-1770
Fax
(586) 725-4080
NPI assigned
Mar 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301086103 MI Primary

Addresses

Primary practice location

34301 23 Mile Rd
Suite 100
Chesterfield, MI 48047-4432

Mailing address

34301 23 Mile Rd
Suite 100
Chesterfield, MI 48047-4432
Phone (586) 725-1770

Other identifiers 1

IdentifierTypeStateIssuer
0502335OtherMIBCBSM PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address paul.paonessa.md@direct.bayareafp.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081106000780 MI Practitioner - Family Practice 3678632577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bay Area Family Physicians, P.C.Group PAC ID 8628040193, 13 clinicians

Practice addresses (Care Compare)

34301 23 Mile Rd
Suite 100
Chesterfield, MI 48047-4432
Phone (586) 725-1770

Hospital & facility affiliations

  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions15
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301086103MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Family Physicians, P.C. Family Medicine CurrentSince Jul 7, 2008 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

34301 23 Mile Rd
Ste 100
Chesterfield, MI 48047
Phone (586) 725-1770

Interoperability endpoints

  • Direct secure messaging: ppaonessa9413@direct.hfhs.org
  • Direct secure messaging: paul.paonessa.1@24454.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24454/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1093985145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34301 23 MILE RD",
            "address_2": "SUITE 100",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480474432",
            "telephone_number": "586-725-1770",
            "fax_number": "586-725-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34301 23 MILE RD",
            "address_2": "SUITE 100",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480474432",
            "telephone_number": "586-725-1770",
            "fax_number": "586-725-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAONESSA",
        "first_name": "PAUL",
        "middle_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-05",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301086103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "0502335",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paul.paonessa.md@direct.bayareafp.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGen Share",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "34301 23 Mile Rd",
            "address_2": "Suite 100",
            "city": "Chesterfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480474432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

Verify at the official NPI Registry.