Paul Padesky, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301101476 Issued in MI

Practice address

20225 E 9 Mile Rd
Suite a
Saint Clair Shores, MI 48080-1775

Phone

(586) 772-1090

NPI assigned

Jul 3, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppadesky1143667@direct.hfhs.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/
• Direct secure messaging: paul.padesky.3@8209.direct.athenahealth.com

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.

• Henry Ford Cornerstone Medical Group

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1851765374
  Medicare reassignment NPD
• Ascension Macomb Oakland Hospital

  dba Michigan Neuro-Ophthalmology & Oculoplastic Surgery

  • Ophthalmology Physician
  • Madison Heights, MI
  • NPI 1114962461
  NPD (past)
• Thomas D Schomaker DO PC

  • Pediatrics Physician
  • Clinton Township, MI
  • NPI 1497906499
  NPD (past)
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD (past)

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1346504438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20225 E 9 MILE RD",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801775",
            "telephone_number": "586-772-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20225 E 9 MILE RD",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801775",
            "telephone_number": "586-772-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADESKY",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301101476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Osterhout
• Karen Ostrowski-Thomas, OTR
• Outpatient Endoscopy & Surgi Center
• Outpatient Endoscopy & Surgi Center
• Kayla Pacic, MA
• Katie Alyssa Padula, M.A
• Kelly Page, LPN
• Dana Marie Paglia-King
• Brynn M Pajtas, D.D.S., M.S.
• Alexxa Palazzolo, MOTRL

• Pediatrics Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.