Individual provider Active NPI

Mark Allen Menestrina, MD

  • Addiction Medicine (Family Medicine) Physician
  • Brighton, MI
National Provider Identifier
1265498059
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
045529 Issued in MI
Practice address
12851 E Grand River
Brighton Hospital
Brighton, MI 48116-8596
Phone
(810) 227-1211
Fax
(810) 227-6893
NPI assigned
Apr 21, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 045529 MI Primary

Addresses

Primary practice location

12851 E Grand River
Brighton Hospital
Brighton, MI 48116-8596

Mailing address

17351 Inkster Rd
Livonia, MI 48152
Phone (734) 421-7997

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414000781 MI Practitioner - Family PracticePractitioner - Addiction Medicine 8325032014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Addiction Medicine
Education
Wayne State University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Challenge of Southeastern MichiganGroup PAC ID 3072944743, 4 clinicians

Practice addresses (Care Compare)

17667 Pierson St
Detroit, MI 48219-2520
Phone (313) 531-0111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045529MIMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Life Challenge of Southeastern Michigan CurrentSince Mar 1, 2020 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265498059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17351 INKSTER RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "734-421-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12851 E GRAND RIVER",
            "address_2": "BRIGHTON HOSPITAL",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481168596",
            "telephone_number": "810-227-1211",
            "fax_number": "810-227-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENESTRINA",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MI",
            "license": "045529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.