NPIMap

Individual provider Active NPI

Theresa M Micke, PA-C

  • Physician Assistant
  • Benson, NC
National Provider Identifier
1033469531
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04279 Issued in NC
Practice address
3333 NC Highway 242 N
Benson, NC 27504-7844
Phone
(919) 894-2011
Fax
(919) 894-7645
NPI assigned
Sep 12, 2012
Last updated
Jun 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04279 NC Primary

Addresses

Primary practice location

3333 NC Highway 242 N
Benson, NC 27504-7844

Mailing address

PO Box 399
Benson, NC 27504-0399
Phone (919) 894-2011

Other names 1

  • Theresa M Jaeger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121016000627 WI Practitioner - Physician Assistant 0143470732 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
77.62
Promoting interoperability
100
Improvement activities
40
Cost
78.08

Merit-based Incentive Payment System (MIPS)

Final score
90.56 of 100Reported as group
Quality
87.43
Promoting interoperability
100
Improvement activities
40
Cost
78.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jun 1, 2018 Accepting new patients
Benson Area Medical Center Current Accepting new patients
Human Services Board Serving North Central Heatlh Care Facility CurrentSince Aug 13, 2023 Accepting new patients
Human Services Board Serving North Central Health Care Facility CurrentSince Aug 13, 2023 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jun 1, 2018 Accepting new patients
Aspirus Wausau Hospital Inc CurrentSince Jun 1, 2018 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Dean Health Systems, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

3333 NC Highway 242 N
Benson, NC 27504
Phone (910) 894-2011

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

1100 Lake View Dr
Wausau, WI 54403
Phone (715) 848-4454

2400 Marshall St
Ste A
Wausau, WI 54403
Phone (715) 848-4600

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

1660 Sue Alan Dr
Wittenberg, WI 54499
Phone (715) 241-5426

Interoperability endpoints

  • Direct secure messaging: theresa-micke@bensonmedical.e-mdsdirect.com
  • Direct secure messaging: tmicke137369@direct.aspirus.org

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1033469531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275040399",
            "telephone_number": "919-894-2011",
            "fax_number": "919-894-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 NC HIGHWAY 242 N",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275047844",
            "telephone_number": "919-894-2011",
            "fax_number": "919-894-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKE",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "JAEGER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Benson, NC

Sources for this page

Verify at the official NPI Registry.