Individual provider Active NPI

Michelle Ciesla, PA-C

  • Medical Physician Assistant
  • Bayonne, NJ
National Provider Identifier
1740752526
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00513400 Issued in NJ
Practice address
904 Bayonne Crossing Way
Bayonne, NJ 07002-5307
Phone
(551) 497-5675
NPI assigned
Dec 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X 25MP00513400 NJ Primary

Addresses

Primary practice location

904 Bayonne Crossing Way
Bayonne, NJ 07002-5307

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

Other practice location 1

2640 14th Ave N
St Petersburg, FL 33713-5813
Phone (858) 444-6013

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
I20190430002140 NJ Practitioner - Physician Assistant 1456693001 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00513400NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ijkg Opco LLC Current Accepting new patients
Summit Medical Group PA CurrentSince Aug 22, 2025 Accepting new patients
Summit Medical Group PA CurrentSince Aug 22, 2025 Accepting new patients

Locations

904 Bayonne Crossing Way
Bayonne, NJ 07002
Phone (551) 497-0072

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

Interoperability endpoints

  • Direct secure messaging: michelle.ciesla.1@2983.direct.athenahealth.com
  • Direct secure messaging: michelle.ciesla@direct.bayonnemedicalcenter.md

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1740752526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 BAYONNE CROSSING WAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070025307",
            "telephone_number": "551-497-5675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2640 14th Ave N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337135813",
            "country_code": "US",
            "telephone_number": "858-444-6013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIESLA",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00513400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.