Individual provider Active NPI

Michaela Kathryn Petito, PA-C

  • Physician Assistant
  • Princeton, NJ
National Provider Identifier
1538056031
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00945600 Issued in NJ
Practice address
325 Princeton Ave
Princeton, NJ 08540-1617
Phone
(609) 924-8131
Fax
(609) 924-8532
NPI assigned
Jun 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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 25MP00945600 NJ Primary

Addresses

Primary practice location

325 Princeton Ave
Princeton, NJ 08540-1617

Mailing address

325 Princeton Ave
Princeton, NJ 08540-1617
Phone (609) 924-8131

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
I20250805000669 NJ Practitioner - Physician Assistant 6103334776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthonj LLCGroup PAC ID 6800225178, 302 clinicians

Practice addresses (Care Compare)

1 Union St
Suite 305
Robbinsville, NJ 08691-4219
Phone (609) 924-8131

11 Centre Dr
Monroe TWP, NJ 08831-1865
Phone (609) 924-8131

200 Charles Ewing Blvd
Suite 170
Ewing, NJ 08628-3451
Phone (609) 924-8131

2315 Route 34
Manasquan, NJ 08736-1444
Phone (732) 974-0404

325 Princeton Ave
Princeton, NJ 08540-1617
Phone (609) 924-8131

5 Plainsboro Rd
Plainsboro, NJ 08536-1915
Phone (609) 924-8131

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00945600NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthonj LLC CurrentSince Aug 4, 2025 Accepting new patients
Orthonj LLC CurrentSince Aug 4, 2025 Accepting new patients

Locations

315 US Highway 206
Hillsborough, NJ 08844
Phone (908) 431-0161

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

11 Centre Dr
Monroe Twp, NJ 08831
Phone (609) 655-3800

5 Plainsboro Rd
Ste 100
Plainsboro, NJ 08536
Phone (609) 750-1600

325 Princeton Ave
Princeton, NJ 08540
Phone (609) 924-5044

1 Union St
Ste 305
Robbinsville, NJ 08691
Phone 6099248131 ext. 4232

200 Charles Ewing Blvd
Ste 170
Trenton, NJ 08628

Interoperability endpoints

  • Direct secure messaging: mpetito@portho1258.srs-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1538056031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETITO",
        "first_name": "MICHAELA",
        "middle_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00945600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.