Individual provider Active NPI

Michela Thorn, PA-C

  • Medical Physician Assistant
  • Raritan, NJ
National Provider Identifier
1790091015
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00239500 Issued in NJ
Practice address
503 Route 202
Raritan, NJ 08869-1574
Phone
(908) 557-9802
NPI assigned
Aug 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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 25MP00239500 NJ
Medical Physician Assistant 363AM0700X 25MP00239500 NJ Primary

Addresses

Primary practice location

503 Route 202
Raritan, NJ 08869-1574

Mailing address

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

Other names 1

  • Miss Michela Thorn 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
I20110323000077 NJ Practitioner - Physician Assistant 2365625779 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
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
25MP00239500NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Mar 1, 2023 Accepting new patients
Summit Medical Group PA CurrentSince Mar 1, 2023 Accepting new patients
Emergency Medical Associates of New Jersey PA PastSince May 10, 2020 Accepting new patients
Clara Maass Emergency Medical Associates LLC Past Accepting new patients
Newton Inpatient Medical Associates LLC Past Accepting new patients

Locations

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

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

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

503 Route 202
Raritan, NJ 08869
Phone (908) 557-9802

Interoperability endpoints

  • Direct secure messaging: michela.thorn.1@2983.direct.athenahealth.com

Organizations & group practices 7

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": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1790091015",
    "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",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 ROUTE 202",
            "city": "RARITAN",
            "state": "NJ",
            "postal_code": "088691574",
            "telephone_number": "908-557-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORN",
        "first_name": "MICHELA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00239500",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00239500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELA",
            "last_name": "THORN",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raritan, NJ

Sources for this page

Verify at the official NPI Registry.