Active NPI
Pasquale B. Iaderosa, MD
- Internal Medicine Physician
- Mount Clemens, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301046401
- Practice address
- 133 S Main St
Suite D
Mount Clemens, MI 48043-2308 - Phone
- (586) 468-1600
- Fax
- (586) 465-0329
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301046401 | MI | Primary |
Addresses
Primary practice location
133 S Main St
Suite D
Mount Clemens, MI 48043-2308
Mailing address
133 S Main St
Mount Clemens, MI 48043-2308
Phone (586) 468-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1836979 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | piaderosa240459@direct.hfhs.org |
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
- Internal Medicine
- Education
- Wayne State University School of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
133 S Main St
Mount Clemens, MI 48043-2308
Phone (586) 468-1600
Hospital & facility affiliations
- Henry Ford Macomb Hospital
- Henry Ford Health Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301046401 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Health Professionals, PLLC | Internal Medicine | Current | Accepting new patients |
| Henry Ford Physician Partners | Internal Medicine | Current | Accepting new patients |
| Henry Ford Macomb Ancillary Services | Current | Accepting new patients | |
| Henry Ford Physician Partners | Current | Accepting new patients |
Locations
2689 Solution Ctr
Chicago, IL 60677
30795 23 Mile Rd
Ste 201
Chesterfield, MI 48047
Phone (586) 421-1600
30795 23 Mile Rd
Ste 207
Chesterfield, MI 48047
Phone (586) 263-7200
133 S Main St
Ste D
Mount Clemens, MI 48043
Phone (313) 465-1326
133 S Main St
Mount Clemens, MI 48043
Phone (586) 329-1880
Interoperability endpoints
- piaderosa240459@direct.hfhs.org
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.
-
- Internal Medicine Physician
- Mount Clemens, MI
- NPI 1427703602
-
- Internal Medicine Physician
- Mount Clemens, MI
- NPI 1841615648
-
- Clinical Medical Laboratory
- Mount Clemens, MI
- NPI 1669864708
-
- Cardiovascular Disease Physician
- Dearborn, MI
- NPI 1366219651
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- General Acute Care Hospital
- Clinton TWP, MI
- NPI 1023114634
-
- General Acute Care Hospital
- Warren, MI
- NPI 1902842735
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608595200000",
"number": "1962409094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 S MAIN ST",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480432308",
"telephone_number": "586-468-1600",
"fax_number": "586-465-0329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 S MAIN ST",
"address_2": "SUITE D",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480432308",
"telephone_number": "586-468-1600",
"fax_number": "586-465-0329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IADEROSA",
"first_name": "PASQUALE",
"middle_name": "B.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2020-12-22",
"certification_date": "2020-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301046401",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1836979",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "piaderosa240459@direct.hfhs.org",
"affiliation": "N",
"address_1": "133 S Main St",
"address_2": "Suite D",
"city": "Mount Clemens",
"state": "MI",
"country_code": "US",
"postal_code": "480432308",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mount Clemens, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.