Active NPI
Jessica E Paonessa, MD
- Urology Physician
- Traverse City, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 4301113807
- Practice address
- 1221 Sixth St Ste 100
Traverse City, MI 49684 - Phone
- (231) 935-0322
- Fax
- (231) 935-0334
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 274692 | NY | |
| Urology Physician | 208800000X | 01071233A | IN | |
| Urology Physician | 208800000X | 4301113807 | MI | Primary |
Addresses
Primary practice location
1221 Sixth St Ste 100
Traverse City, MI 49684
Mailing address
1221 Sixth St Ste 100
Traverse City, MI 49684-2359
Phone (231) 935-0322
Other practice location 1
4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-3700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03884526 | Medicaid | NY | |
| 201112070 | Medicaid | IN | |
| 000000792827 | Other | IN | ANTHEM PIN |
Other names 1
- Ms. Jessica Erin Stevens
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Wayne State University School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3922 Cedar Run Rd
Bay Area
Traverse City, MI 49684-9687
Phone (231) 935-0322
Hospital & facility affiliations
- Munson Medical Center
- Munson Healthcare Cadillac Hospital
- Kalkaska Memorial Health Center
- Munson Healthcare Manistee Hospital
- Paul Oliver Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 35 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301113807 | MI | MD | Urology Physician |
| 274692 | NY | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munson Medical Center | Current | Accepting new patients | |
| Munson Medical Center | Urology | Current | Accepting new patients |
| Munson Medical Center | Current | Accepting new patients | |
| Munson Medical Center | Past | Accepting new patients |
Locations
2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031
400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200
3922 Cedar Run Rd
Traverse City, MI 49684
Phone (231) 392-0430
1221 Sixth St
Ste 100
Traverse City, MI 49684
Phone (231) 392-8400
1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000
Interoperability endpoints
- jpaonessa@direct.mhc.net
Organizations & group practices 4
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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Traverse City, MI
- NPI 1083761860
-
- Urology Physician
- Traverse City, MI
- NPI 1427466499
-
- Psychiatric Hospital Unit
- Traverse City, MI
- NPI 1891586103
-
- Family Medicine Physician
- Traverse City, MI
- NPI 1881623031
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Kalkaska, MI
- NPI 1497751309
-
- General Acute Care Hospital
- Cadillac, MI
- NPI 1841696754
-
- General Acute Care Hospital
- Manistee, MI
- NPI 1407949191
-
- General Acute Care Hospital
- Traverse City, MI
- NPI 1952307852
-
- Critical Access Hospital
- Frankfort, MI
- NPI 1427054360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1386760122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 SIXTH ST STE 100",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842359",
"telephone_number": "231-935-0322",
"fax_number": "231-935-0334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 SIXTH ST STE 100",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "49684",
"telephone_number": "231-935-0322",
"fax_number": "231-935-0334"
}
],
"practiceLocations": [
{
"address_1": "4900 Broad Rd",
"address_purpose": "LOCATION",
"city": "Syracuse",
"state": "NY",
"postal_code": "13215",
"country_code": "US",
"telephone_number": "315-492-3700",
"fax_number": "315-492-3596",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAONESSA",
"first_name": "JESSICA",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "274692",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IN",
"license": "01071233A",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MI",
"license": "4301113807",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03884526",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201112070",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "000000792827",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "STEVENS",
"middle_name": "ERIN",
"prefix": "MS.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.