Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Mark Peter Mastromonaco, MD

Individual provider Family Medicine Physician · NPI 1659990059

Dr. Mark Peter Mastromonaco, MD is a Family Practice in Saint Clair Shores, Michigan. Qualified in 2019, 7 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
7
Licensed in
MI
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

21400 E 11 Mile Rd
Saint Clair Shores, MI 48081-1566
Phone: (586) 498-4400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 4351046408 (MI)

Record details

NPI number1659990059
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 15, 2020
Last updated in NPPESApril 15, 2020
Certification dateApril 15, 2020
Mailing address468 Cadieux Rd, Grosse Pointe, MI 48230-1507

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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