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MIRANDA BASTO PAC
NPI 1538965256
Physician Assistant in Lawrenceville, GA

Active since February 22, 2025PECOS EnrolledAccepts Medicare Assignment
1900 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043(770) 237-3475(770) 237-3756 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Miranda Basto Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRANDA BASTO PAC (NPI 1538965256) is an individual physician assistant in Lawrenceville, Georgia, licensed in Georgia (13251) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1538965256
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMIRANDA BASTOCredential: PAC
Location Address1900 RIVERSIDE PKWYLawrenceville, GA 30043-5925
Mailing Address1900 Riverside PkwyLawrenceville, GA 30043-5925 · (770) 237-3475 · Fax (770) 237-3756
Phone(770) 237-3475
Fax(770) 237-3756
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 22, 2025
Last NPPES UpdateJuly 25, 2025
NPPES CertifiedJuly 25, 2025
✔ NPI 1538965256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in GA · 13251
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1900 RIVERSIDE PKWY, Lawrenceville, GA 30043
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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

Miranda Basto Pac 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.

PECOS PAC ID7618476748
PECOS Enrollment IDI20250815003866
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30043 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CGA CARE OF GA, LLC
Internal Medicine (Cardiovascular Disease)
1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA 30043
Gwinnett County (615) 386-0064
CURTIS WRIGHT BAZEMORE PT, ATC
Physical Therapist
1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 237-3475
TAMMY BRENT PTA
Physical Therapy Assistant
1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 237-3475
MR. HARRIS A PATEL PA-C, ATC
Physician Assistant
1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 471-7909
SPORTS MEDICINE SOUTH OF GWINNETT LLC
Orthopaedic Surgery (Sports Medicine)
1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 237-3475
LINDSEY ANN GARRISON PA-C
Physician Assistant
1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 237-3475
JENNIFER ANN SWEIGART PA-C
Physician Assistant (Medical)
1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 237-3475
KATIE MICHEL HICKMAN PA-C
Physician Assistant
1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 237-3475

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 Miranda Basto's NPI number?

The NPI number for Miranda Basto is 1538965256. It was assigned to this individual provider in the NPPES registry on February 22, 2025.

Where is Miranda Basto located?

Miranda Basto practices at 1900 Riverside Pkwy, Lawrenceville, GA 30043. The listed phone number is (770) 237-3475.

What is Miranda Basto's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Miranda Basto enrolled in Medicare?

Yes. Miranda Basto 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.

When was this NPI record last updated?

The NPPES record for Miranda Basto was last updated on July 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.