Mia Deritis
NPI 1073063012ActiveIndividual· Physician Assistant· Pennington, NJ
Physician Assistant with Cmc Department of Medicine Group PA, practicing in Pennington, New Jersey. Mostly services rather than prescriptions: Medicare paid $4,233 for 46 patients in 2024, with only 30 Part D claims. Lists Cooper University Hospital as a hospital affiliation.
Overview
| NPI | 1073063012 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Oct 13, 2016 |
| Last updated in NPPES | Dec 9, 2024 |
| Certified by provider | Dec 9, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 25MP00518400 | NJ |
| Physician Assistant, Medical | 363AM0700X | 25MP00518400 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (NJ) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 46 |
|---|---|
| Services billed | 71 across 9 procedure codes |
| Paid by Medicare | $4,233 |
Part D prescriptions in 2024
| Prescriptions (claims) | 30 · 54 30-day fills |
|---|---|
| Patients | 13 |
| Total drug cost | $544.05 |
| Generic share | 100% of claims |
Education and affiliations
| Graduation year | 2018 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Cmc Department of Medicine Group PACamden, NJ · 478 clinicians
Hospital affiliation
- Cooper University HospitalCamden, NJ
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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