Kimberley D Michelson-Bandola, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

MP165 Issued in NJ

Practice address

95 Madison Ave Suite 201
Mid-Atlantic Surgical Associates
Morristown, NJ 07960

Phone

(973) 971-7300

Fax

(973) 984-7019

NPI assigned

Aug 16, 2006

Last updated

Mar 12, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morristown Medical Center Hospital, Morristown, NJ, CCN 310015

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.

• Practice Associates Medical Group

  dba Atlantic Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  Medicare reassignment Care Compare group
• Mid-Atlantic Surgical Assoc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Morristown, NJ
  • NPI 1619977741
  NPD (past)
• Mid-Atlantic Surgical Associates

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Neptune, NJ
  • NPI 1023000130
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hospital Corp.

  dba Morristown Medical Center

  • General Acute Care Hospital
  • Morristown, NJ
  • NPI 1053384776
  Care Compare affiliation

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1528171485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "address_2": "MID-ATLANTIC SURGICAL ASSOCIATES",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "07960",
            "telephone_number": "973-971-7300",
            "fax_number": "973-984-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MADISON AVE SUITE 201",
            "address_2": "MID-ATLANTIC SURGICAL ASSOCIATES",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "07960",
            "telephone_number": "973-971-7300",
            "fax_number": "973-984-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELSON-BANDOLA",
        "first_name": "KIMBERLEY",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "MP165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael D. Robinson, M.D., P.a.
• Michael Marcello DC PA
• Christopher Stephen Michaels, PH.D.
• Leighanne Katherine Michel, DO
• Philippa Michel
• Amanda Michko, LCSW
• Mid-Atlantic Surgical Assoc.
• Robert A. Mieliwocki, M.S.W.
• Meghan Mihalik, MD
• Mark Mikaeal, PHARMD

• Surgical Physician Assistant in Morristown, NJ
• Providers in Morristown, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.