Individual provider Active NPI

Monica Joanna Petela

  • Nurse Practitioner
  • Mount Clemens, MI
National Provider Identifier
1831781632
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704322913 Issued in MI
Practice address
1030 Harrington St Ste 101
Mount Clemens, MI 48043-2967
Phone
(586) 468-8500
NPI assigned
Feb 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704322913 MI Primary

Addresses

Primary practice location

1030 Harrington St Ste 101
Mount Clemens, MI 48043-2967

Mailing address

1030 Harrington St Ste 101
Mount Clemens, MI 48043-2967

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310000784 MI Practitioner - Nurse Practitioner 9032525449 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren MacombGroup PAC ID 8921912791, 131 clinicians

Practice addresses (Care Compare)

1030 Harrington St
Suite 101
Mount Clemens, MI 48043-2967
Phone (586) 468-8500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Health Corporation of Southeastern Michigan CurrentSince May 2, 2022 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Semi Medical Group CurrentSince Dec 9, 2020 Accepting new patients
McLaren Macomb CurrentSince Apr 13, 2024 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Semi Medical Group CurrentSince Dec 9, 2020 Accepting new patients
Henry Ford Health Providence Hospital Nurse Practitioner CurrentSince Dec 1, 2021 Accepting new patients
Seton Health Corporation of Southeastern Michigan CurrentSince May 2, 2022 Accepting new patients
McLaren Macomb Past Accepting new patients

Locations

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

22201 Moross Rd
Ste 214
Detroit, MI 48236
Phone (313) 343-7110

1400 Genesys Pkwy
#B136
Grand Blanc, MI 48439
Phone (810) 606-7629

1 Genesys Pkwy
Ste 3452
Grand Blanc, MI 48439
Phone (248) 849-2600

19229 Mack Ave
Ste 38
Grosse Pointe Woods, MI 48236
Phone (313) 647-3900

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

1030 Harrington St
Ste 101
Mount Clemens, MI 48043
Phone (586) 464-4010

22255 Greenfield Rd
Ste 550
Southfield, MI 48075
Phone (586) 226-6161

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

16001 W 9 Mile Rd
Fl 3
Southfield, MI 48075
Phone (248) 849-2600

11900 E 12 Mile Rd
Ste 308
Warren, MI 48093
Phone (586) 574-5080

30117 Schoenherr Rd
Ste 400
Warren, MI 48088
Phone (586) 552-4848

Organizations & group practices 10

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 2

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": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1831781632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON ST STE 101",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON ST STE 101",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432967",
            "telephone_number": "586-468-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETELA",
        "first_name": "MONICA",
        "middle_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704322913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.