S MICHELLE THORNBLADE PA C
NPI 1629079454
Physician Assistant in Waldorf, MD

Active since August 02, 2005PECOS Enrolled
3975 SAINT CHARLES PKWY, WALDORF, MD 20602(301) 645-6800(301) 645-8696 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About S Michelle Thornblade Pa C NPPES

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

S MICHELLE THORNBLADE PA C (NPI 1629079454) is an individual physician assistant in Waldorf, Maryland, licensed in Maryland (C0002969) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629079454
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameS MICHELLE THORNBLADECredential: PA C
Location Address3975 SAINT CHARLES PKWYWaldorf, MD 20602-2683
Mailing Address330 N Howard StBaltimore, MD 21201-3610 · (410) 576-1400 · Fax (410) 576-7600
Fax(301) 645-8696
Sole ProprietorNo
Enumeration DateAugust 2, 2005
Last NPPES UpdateJuly 8, 2007
NPI 1629079454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MD · C0002969
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3975 SAINT CHARLES PKWY, Waldorf, MD 20602

Other Names 1

Former Name (1)S Michelle Westphal

Other Identifiers 4

OtherPA02088TX · Pa License (inactive Stat
Medicare ID-Type Unspecified8A3266
Medicare UPINS62459
Other1421CO · License (expired)

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

S Michelle Thornblade Pa C 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20602 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
$89.75 typical visit price
range $57.99 – $175.57
Typical copayment $22.43 (range $14.49 – $43.89)
Most-billed visit code 99203
Established Patient
$72.23 typical visit price
range $18.66 – $143.02
Typical copayment $18.05 (range $4.66 – $35.75)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629079454, enumerated as an "individual" on August 02, 2005.

The provider is located at 3975 SAINT CHARLES PKWY WALDORF, MD 20602 and the phone number is (301) 645-6800.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Mountain. Please consult your insurance carrier or call the provider to verify.