Michael Charles Senisch, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00011800 Issued in NJ

Practice address

414 Tatum St
Woodbury, NJ 08096-3499

Phone

(856) 848-3880

NPI assigned

Mar 13, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Exigence New Jersey, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Salem, NJ
  • NPI 1376593137
  NPD (past)
• Leeds Emergency Physicians

  • Emergency Medicine Physician
  • Atlantic City, NJ
  • NPI 1326248667
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497888259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 PINDALE DR",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083024901",
            "telephone_number": "856-455-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 TATUM ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080963499",
            "telephone_number": "856-848-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENISCH",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00011800",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0000539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Schwartz, MD
• Jennifer Schwartz
• Scott a Brown, D.C. P.a
• Monica Janel Scott, PT
• Gady Ross Segal, DMD
• Services to Overcome Drug Abuse Among Teenagers, Inc. (SODAT of New Jersey, Inc.)
• Services to Overcome Drug Abuse Among Teenagers, Inc. (SODAT of NJ, Inc)
• Rasesh Shah, M.D.
• Richard A. Shaw, D.O.
• Robert Sheiman, MD

• Physician Assistant in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.