DR. MARK ALLEN MENESTRINA (MD) – Addiction Medicine (Family Medicine) Physician, NPI 1265498059

DR. MARK ALLEN MENESTRINA (MD) is a healthcare provider. based in Livonia, Michigan. specializing in FAMILY PRACTICE, ADDICTION MEDICINE. They hold the professional credentials MD. They hold a License No. 045529 (MI). The NPI Number for DR. MARK ALLEN MENESTRINA (MD) is 1265498059

Main info

Male
47 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK ALLEN MENESTRINA (MD)
NPI
1265498059
Phone
(734) 421-7997
Address
17351 INKSTER RD
Enumeration Date
21 April 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3135310111
Graduation Year
1979 (47 years ago)
PAC ID
8325032014
Group Practice PAC ID
3072944743
Professional Enrollment ID
I20040414000781
Address ID
MI482192520DE17667STXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,418 FAMILY PRACTICE in MI

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Provider Addresses for DR. MARK ALLEN MENESTRINA (MD)

  • 17351, Inkster Road, Livonia, Wayne County, Michigan, 48152, United States

    LIVONIA, MI 48152

    Phone: (734) 421-7997

    Type: Mailing

  • Henry Ford Brighton Center for Recovery, 12851, East Grand River Avenue, Brighton, Livingston County, Michigan, 48116, United States

    BRIGHTON HOSPITAL

    BRIGHTON, MI 481168596

    Phone: (810) 227-1211

    Fax: (810) 227-6893

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-04-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040414000781IFamily PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48152)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072944743View full group profile
NameSpecialtyState
Mental Health CounselorMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

How is DR. MARK ALLEN MENESTRINA (MD) identified in CMS data?
CMS-hosted NPPES data lists DR. MARK ALLEN MENESTRINA (MD) with NPI 1265498059.
Can I rely on DR. MARK ALLEN MENESTRINA (MD) being an active provider?
As of the registry snapshot, DR. MARK ALLEN MENESTRINA (MD) is marked active.
What is DR. MARK ALLEN MENESTRINA (MD)'s primary classification?
Addiction Medicine (Family Medicine) Physician is the headline specialty for DR. MARK ALLEN MENESTRINA (MD) here. Clinical services aligned with this taxonomy classification.
Where is DR. MARK ALLEN MENESTRINA (MD) based?
DR. MARK ALLEN MENESTRINA (MD) is tied to Livonia, Michigan in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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