Rachael Theresa Detore

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00878300 Issued in NJ

Practice address

342 Hamburg Tpke Ste 202
Wayne, NJ 07470-2166

Phone

(973) 870-0777

NPI assigned

Oct 6, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

One Oak Medical Group LLCGroup PAC ID 9931467941, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• One Oak Medical Group, LLC

  • Orthopaedic Surgery Physician
  • Wayne, NJ
  • NPI 1669997359
  Medicare reassignment Care Compare group NPD

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

• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Pompton Plains, NJ
  • NPI 1811994809
  Care Compare affiliation

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1982154589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WYCKOFF CT",
            "city": "ASBURY",
            "state": "NJ",
            "postal_code": "088021091",
            "telephone_number": "908-537-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 HAMBURG TPKE STE 202",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702166",
            "telephone_number": "973-870-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETORE",
        "first_name": "RACHAEL",
        "middle_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00878300",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natacha Derival
• Elizabeth Derka, PHARMD
• Jamie Deruyter Swart, LPC
• Meghna Desai
• Nawal M Desoky, M.D.
• Diane Dettmore
• Jeffrey Edwin Devack, D.D.S.
• Malvi Devanathan
• Aynur A. Devli, MD
• Gregory Devries, D.M.D.

• Physician Assistant in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.