MIA R DERICCO
NPI 1194407999
Physician Assistant - Medical in Bay Shore, NY
About Mia R Dericco NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MIA R DERICCO (NPI 1194407999) is an individual medical provider in Bay Shore, New York, licensed in New York (030197) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, is affiliated with Ns/lij Hs Southside Hospital, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mia R Dericco is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ns/Lij Hs Southside Hospital
Acute Care Hospitals · Bay Shore, NYNorth Shore University Hospital
Acute Care Hospitals · Manhasset, NYLong Island Jewish Medical Center
Acute Care Hospitals · New Hyde Park, NYOther Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BAY SHORE, NY 11706
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mia Dericco's NPI number?
The NPI number for Mia Dericco is 1194407999. It was assigned to this individual provider in the NPPES registry on August 2, 2023.
Where is Mia Dericco located?
Mia Dericco practices at 270 E Main St, Bay Shore, NY 11706. The listed phone number is (631) 591-7470.
What is Mia Dericco's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Mia Dericco enrolled in Medicare?
Yes. Mia Dericco is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Mia Dericco affiliated with any hospitals?
According to CMS data, Mia Dericco is affiliated with Ns/Lij Hs Southside Hospital, North Shore University Hospital and Long Island Jewish Medical Center.
When was this NPI record last updated?
The NPPES record for Mia Dericco was last updated on August 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mia R Dericco · NPI 1194407999
Medical physician in Bay Shore, New York. Individual provider, active in the CMS NPPES registry since August 2, 2023.
## Identity
- **NPI:** 1194407999 (Entity type: Individual)
- **Enumerated:** August 2, 2023
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 030197 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 270 E MAIN ST, Bay Shore, NY 11706-8420
- **Phone:** (631) 591-7470
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** August 2, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1194407999) · Data from the CMS NPPES public registry.