Mia R Dericco, in Bay Shore, NY - Medicare Physician Assistant

Mia R Dericco, is a medicare enrolled "Physician Assistant - Medical" in Bay Shore, New York. Her current practice location is 270 E Main St, Bay Shore, New York. You can reach out to her office (for appointments etc.) via phone at (631) 591-7470.

Mia R Dericco is licensed to practice in New York (license number 030197) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1194407999.

Contact Information

	Mia R Dericco,
	270 E Main St, Bay Shore, NY 11706-8420
	(631) 591-7470
	Not Available

Map and Direction

Provider's Profile

Full Name	Mia R Dericco
Gender	Female
Speciality	Physician Assistant - Medical
Location	270 E Main St, Bay Shore, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1194407999
Provider Enumeration Date: 08/02/2023
Last Update Date: 08/02/2023

Medicare PECOS Information:

PECOS PAC ID: 4587011697
Enrollment ID: I20231111000108

Medical Identifiers

Medical identifiers for Mia R Dericco such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1194407999	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	030197 (New York)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mia R Dericco is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mia R Dericco, 39 Woodland Dr, Smithtown, NY 11787-1847 Ph: (631) 848-2092	Mia R Dericco, 270 E Main St, Bay Shore, NY 11706-8420 Ph: (631) 591-7470

Reviews and Comments

Physician Assistant Nurses in Bay Shore, NY

Priyanshi Chandiwala, Physician Assistant Medicare: Medicare Enrolled Practice Location: 301 E Main St, Bay Shore, NY 11706 Phone: 631-968-3000
Erik Schaeperkoetter, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 301 E Main St, Bay Shore, NY 11706 Phone: 631-968-3000
Elizabeth Scuderi, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1555 Sunrise Hwy, Bay Shore, NY 11706 Phone: 631-968-0588
Mrs. Deborah Anne Maresca-palmieri, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 301 E Main St, Bay Shore, NY 11706 Phone: 631-968-3000
Ms. Sonya Reid, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 301 E Main St, Bay Shore, NY 11706 Phone: 631-968-3000
Ms. Lisa Ann Morris, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 301 E Main St, Bay Shore, NY 11706 Phone: 631-968-3000
Danielle Sophia Mirabella, Physician Assistant Medicare: Medicare Enrolled Practice Location: 301 E Main St, Bay Shore, NY 11706 Phone: 631-968-3000

Mia R Dericco, - Medicare Physician Assistant in Bay Shore, NY