Individual provider Active NPI

Michele Lynne Lohman, PA-C

  • Surgical Physician Assistant
  • Wayne, NJ
National Provider Identifier
1366658478
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00148300 Issued in NJ
Practice address
145 US Highway 46
Suite 304
Wayne, NJ 07470-6830
Phone
(973) 826-1540
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00148300 NJ Primary

Addresses

Primary practice location

145 US Highway 46
Suite 304
Wayne, NJ 07470-6830

Mailing address

PO Box 4059
Wayne, NJ 07474-4059
Phone (973) 826-1540

Other identifiers 1

IdentifierTypeStateIssuer
275284OtherNJGRP PTAN QUALITY SURGICAL SERVICES LLC

Other names 1

  • Michele Lynne Deoliveira Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20090127000100 NJ Practitioner - Physician Assistant 5395809990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Spinal Care and Associates, LLCGroup PAC ID 7315096310, 6 clinicians

Practice addresses (Care Compare)

160 E Hanover Ave
Morristown, NJ 07960-3150
Phone (973) 538-0900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00148300NJMDSurgical Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1366658478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4059",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074744059",
            "telephone_number": "973-826-1540",
            "fax_number": "855-834-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 US HIGHWAY 46",
            "address_2": "SUITE 304",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706830",
            "telephone_number": "973-826-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOHMAN",
        "first_name": "MICHELE",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00148300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP PTAN QUALITY SURGICAL SERVICES LLC",
            "identifier": "275284",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "DEOLIVEIRA",
            "middle_name": "LYNNE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.