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DR. MARIA THERESA MICALE DO
NPI 1619949252
Pediatrics in Red Bank, NJ

Active since February 07, 2006PECOS Enrolled
225 HIGHWAY 35 STE 102, RED BANK, NJ 07701(732) 530-5515(732) 530-5516 Get Directions Write a Review

NPPES record last updated: March 22, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Maria Theresa Micale Do NPPES

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

DR. MARIA THERESA MICALE DO (NPI 1619949252) is an individual pediatrics provider in Red Bank, New Jersey, licensed in New Jersey (25MB06865200) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Wall Township.

NPPES Registry Identity

NPI1619949252
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. MARIA THERESA MICALECredential: DO
Location Address225 HIGHWAY 35 STE 102Red Bank, NJ 07701-5919
Mailing Address401 Route 73 N Ste 320Marlton, NJ 08053-3426 · (732) 530-5515 · Fax (732) 530-5516
Phone(732) 530-5515
Fax(732) 530-5516
Sole ProprietorYes
Enumeration DateFebruary 7, 2006
Last NPPES UpdateMarch 22, 2023
NPPES CertifiedMarch 22, 2023
✔ NPI 1619949252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NJ · 25MB06865200
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
225 HIGHWAY 35 STE 102, Red Bank, NJ 07701
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Secondary Practice Location 1

Location 13350 Highway 138, Building 2, Suite 126Wall Township, NJ 07719-9693 · Phone (732) 280-6455 · Fax (732) 280-6456

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Maria Theresa Micale Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Maria Micale reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Advocare, LLC
55 mi
Pediatrics
401 ROUTE 73 N STE 320
Marlton, NJ 08053
  • Reassigned Medicare billing, New Jersey enrollment
  • 909 clinicians in this Medicare group
NPI 1770538696 (856) 872-7055

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 07701 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
$94.90 typical visit price
range $61.59 – $185.05
Typical copayment $23.72 (range $15.39 – $46.26)
Most-billed visit code 99203
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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 2

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

ADVOCARE , LLC
Pediatrics
225 HIGHWAY 35 STE 102
RED BANK, NJ 07701
Monmouth County (732) 530-5515
JACKLYN LILLIAN IGNIZIO NURSE PRACTITIONER
Nurse Practitioner (Pediatrics)
225 HIGHWAY 35 STE 102
RED BANK, NJ 07701
Monmouth County (732) 530-5515

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 Maria Micale's NPI number?

The NPI number for Maria Micale is 1619949252. It was assigned to this individual provider in the NPPES registry on February 7, 2006.

Where is Maria Micale located?

Maria Micale practices at 225 Highway 35 Ste 102, Red Bank, NJ 07701. The listed phone number is (732) 530-5515.

What is Maria Micale's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Maria Micale enrolled in Medicare?

Yes. Maria Micale is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Maria Micale's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Maria Micale reassigns Medicare benefits to Advocare, LLC (Marlton, NJ). 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 Maria Micale's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Maria Micale accept?

Health plans from Oscar Health list Maria Micale 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 Maria Micale was last updated on March 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.