SEAN MICHAEL ETHERIDGE (PA-C) – Physician Assistant, NPI 1215547716

SEAN MICHAEL ETHERIDGE (PA-C) is a healthcare provider. based in Oakland, New Jersey. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA2612 (ME). The NPI Number for SEAN MICHAEL ETHERIDGE (PA-C) is 1215547716

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
SEAN MICHAEL ETHERIDGE (PA-C)
NPI
1215547716
Phone
(201) 783-5471
Address
38 ACADEMY CIR
Enumeration Date
9 August 2020
Last Update Date
9 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2078859905
Graduation Year
2020 (6 years ago)
PAC ID
9335516491
Group Practice PAC ID
7517860588
Professional Enrollment ID
I20240803000348
Address ID
ME041023134PO22XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,167 PHYSICIAN ASSISTANT in ME

Provider Addresses for SEAN MICHAEL ETHERIDGE (PA-C)

  • 38 ACADEMY CIR

    OAKLAND, NJ 074362625

    Phone: (201) 783-5471

    Type: Mailing

  • 92 CAMPUS DR STE C

    SCARBOROUGH, ME 040747229

    Phone: (207) 797-5753

    Type: Location

  • 1 ROBERT WOOD JOHNSON PL

    NEW BRUNSWICK, NJ 089011928

    Phone: (732) 828-3000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $56.

Total Amount is formed as General ($56) + Research ($0) + Ownership ($0) = $56.

Last reported payment date: 2024-09-09 • Largest payer in this snapshot: Janssen Biotech, Inc. ($31).

Total Amount

$56

General + Research + Ownership

Payments

3

Total payment records

General Amount

$56

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221101003483IPhysician AssistantNJTBD
I20240803000348IPhysician AssistantMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes5723$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes2312$0
View full utilization report →

Insurance plans in this area (ZIP 07436)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517860588View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm SEAN MICHAEL ETHERIDGE (PA-C)'s NPI?
Yes. SEAN MICHAEL ETHERIDGE (PA-C) is listed with NPI 1215547716 in the public NPI dataset.
Is SEAN MICHAEL ETHERIDGE (PA-C) listed as active for patients and plans?
The listing shows SEAN MICHAEL ETHERIDGE (PA-C) as active in the NPI system.
What is SEAN MICHAEL ETHERIDGE (PA-C)'s primary classification?
Physician Assistant is the headline specialty for SEAN MICHAEL ETHERIDGE (PA-C) here. Clinical services aligned with this taxonomy classification.
Does SEAN MICHAEL ETHERIDGE (PA-C) list a practice location?
Patients near Oakland, New Jersey may find SEAN MICHAEL ETHERIDGE (PA-C) in results; validate coverage separately.
Is the information about SEAN MICHAEL ETHERIDGE (PA-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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