Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Rachael Theresa Detore

Individual provider Physician Assistant · NPI 1982154589

Rachael Theresa Detore is a Physician Assistant in Wayne, New Jersey. Qualified in 2024, 2 years ago. Practices with One Oak Medical Group LLC, a 23-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
2
Licensed in
NJ
In the registry since
2016
Specialties on file
3
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Practice location Address checks out

342 Hamburg Tpke Ste 202
Wayne, NJ 07470-2166
Phone: (973) 870-0777
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 25MP00878300 (NJ)
Athletic Trainer Taxonomy 2255A2300X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1982154589
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 6, 2016
Last updated in NPPESOctober 25, 2024
Certification dateOctober 25, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice One Oak Medical Group Llc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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