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DEJ NTSHIAB THOR PMHNP
NPI 1255138061
Nurse Practitioner - Psychiatric/Mental Health in Racine, WI

Active since February 27, 2025PECOS EnrolledAccepts Medicare Assignment
3726 RUBY AVE, RACINE, WI 53402(262) 672-3612 Get Directions Write a Review

NPPES record last updated: February 27, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dej Ntshiab Thor Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEJ NTSHIAB THOR PMHNP (NPI 1255138061) is an individual psychiatric/mental health provider in Racine, Wisconsin, licensed in Wisconsin (1656233) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1255138061
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameDEJ NTSHIAB THORCredential: PMHNP
Location Address3726 RUBY AVERacine, WI 53402-3076
Mailing Address3726 Ruby AveRacine, WI 53402-3076
Phone(262) 672-3612
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateFebruary 27, 2025
NPPES CertifiedFebruary 27, 2025
✔ NPI 1255138061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in WI · 1656233
3726 RUBY AVE, Racine, WI 53402
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dej Ntshiab Thor Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739601402
PECOS Enrollment IDI20250321003429
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Dej Thor reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ganesha Institute Of Neurology And Psychiatry Sc
13 mi
Neurology
4600 GREEN BAY RD
Kenosha, WI 53144
  • Reassigned Medicare billing, Wisconsin enrollment
  • 16 clinicians in this Medicare group
NPI 1619731320 (262) 286-1860

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53402 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VASHIR JIM XIONG LAC
Acupuncturist
3726 RUBY AVE
RACINE, WI 53402
Racine County (414) 234-8544

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dej Thor's NPI number?

The NPI number for Dej Thor is 1255138061. It was assigned to this individual provider in the NPPES registry on February 27, 2025.

Where is Dej Thor located?

Dej Thor practices at 3726 Ruby Ave, Racine, WI 53402. The listed phone number is (262) 672-3612.

What is Dej Thor's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Dej Thor enrolled in Medicare?

Yes. Dej Thor is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Dej Thor's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dej Thor reassigns Medicare benefits to Ganesha Institute Of Neurology And Psychiatry Sc (Kenosha, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dej Thor's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dej Thor accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and UnitedHealthcare list Dej Thor as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dej Thor was last updated on February 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.