John Joseph Pietrofesa, ED.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301005293 Issued in MI

Practice address

74 W Long Lake Rd
Suite 104
Bloomfield Hills, MI 48304-2769

Phone

(248) 642-6066

Fax

(248) 642-5739

NPI assigned

Jan 17, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Miami, LM Miller School of Medicine, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affiliated Psychologists of Michigan, P.C.Group PAC ID 8426233248, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Affiliated Psychologists of Michigan, P.C.

  • Psychologist
  • Bloomfield Hills, MI
  • NPI 1396918199
  Care Compare group NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649322181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483030099",
            "telephone_number": "248-646-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 W LONG LAKE RD",
            "address_2": "SUITE 104",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483042769",
            "telephone_number": "248-642-6066",
            "fax_number": "248-642-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETROFESA",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301005293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "039078",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physician Universe, PLLC
• Physicians Compounding Pharmacy
• Sherry Lee Pianko, LMSW
• Albert Pierce, MD
• Cathy Joan Pietrofesa, PH.D.
• Rossitza Prokopieva Pironkova, M.D.
• Jennifer Rebecca Pitts, DPT
• Jennifer Leigh Place, OD
• Mark A Pleatman, M.D.
• Patricia Ann Plopa, PH.D.

• Psychologist in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.