Mia Dericco
NPI 1194407999 · Medical Physician Assistant · Bay Shore, NY
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mia Dericco is a Medical Physician Assistant provider in Bay Shore, NY (NPI 1194407999).
Provider details
- NPI number
- 1194407999
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 030197 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
2 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
140 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Visit Complexity Inherent to Evaluation and Management Associated With Medical Care Services That Serve As the Continuing Focal Point for All Needed Health Care Services And/Or With Medical Care Services That Are Part of Ongoing Care Related to a Patient'SG2211 | 57 | $16 |
| New Patient Office Or Other Outpatient Visit With a High Level of Medical Decision Making, If Using Time, 60 Minutes Or More99205 | 35 | $214 |
| Established Patient Office Or Other Outpatient Visit With High Level of Medical Decision Making, If Using Time, 40 Minutes Or More99215 | 23 | $174 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 13 | $124 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 12 | $163 |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 7 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Clopidogrel Bisulfatebrand: Clopidogrel | 41 | 24 |
| Gabapentin | 39 | 13 |
| Atorvastatin Calcium | 19 | 12 |
| Apixabanbrand: Eliquis | 17 | — |
| Donepezil Hcl | 15 | — |
| Divalproex Sodium | 14 | — |
| Ticagrelorbrand: Brilinta |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$28 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-08-02
- Last updated
- 2023-08-02
- Certified
- 2023-07-14
Frequently asked questions
- What is Mia Dericco's NPI number?
- Mia Dericco's National Provider Identifier (NPI) is 1194407999, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mia Dericco's specialty?
- Mia Dericco is listed in the NPPES registry with a primary specialty of Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Mia Dericco located?
- Mia Dericco's practice location on file with NPPES is 270 E Main St, Bay Shore, NY 11706-8420.
- What is Mia Dericco's phone number?
- The practice phone number listed in the NPPES registry for Mia Dericco is (631) 591-7470.
- Does Mia Dericco accept Medicare?
- Mia Dericco is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mia Dericco's NPI active?
- Yes — Mia Dericco's NPI (1194407999) is active in the NPPES registry as of the last update on 2023-08-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.