Michele Theresa Gilsenan, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

MB53933 Issued in NJ

Practice address

67 Walnut Ave
Clark, NJ 07066-1640

Phone

(732) 388-7300

Fax

(732) 388-1330

NPI assigned

Mar 10, 2006

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Sports Medicine

Education

University of New England, College of Osteo Medicine, 1988

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: michele.gilsenan.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group
• Sports Extra PC

  • Sports Medicine (Family Medicine) Physician
  • Clark, NJ
  • NPI 1346296969
  NPD (past) Authorized official

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1821066283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 WALNUT AVE",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661640",
            "telephone_number": "732-388-7300",
            "fax_number": "732-388-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 WALNUT AVE",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661640",
            "telephone_number": "732-388-7300",
            "fax_number": "732-388-1330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "399 State Route 10",
            "address_purpose": "LOCATION",
            "city": "East Hanover",
            "state": "NJ",
            "postal_code": "079363530",
            "country_code": "US",
            "telephone_number": "908-557-9808",
            "fax_number": "908-557-9809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILSENAN",
        "first_name": "MICHELE",
        "middle_name": "THERESA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NJ",
            "license": "MB53933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Gay
• Michael Genereux, D.O.
• Alin George, DPT
• Christine Ila Gerber, MD
• Aphnie Germain, DO
• Alan F Goldstein, MD
• David S Goldstein, M.D.
• Andrew P Gonzalez, LAC
• Bryan E Gorczyca, DPT
• James William Gordon Jr.

• Sports Medicine (Family Medicine) Physician in Clark, NJ
• Providers in Clark, NJ by specialty
• Sports Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.