Mia R. Dericco
NPI 1194407999ActiveIndividual· Physician Assistant, Medical· Bay Shore, NY
Physician Assistant, Medical with North Shore-Lij Medical PC, practicing in Bay Shore, New York. Their prescriptions cost Medicare Part D more than their services did: $39,491 for 251 claims, against $12,777 paid for services in 2024. Abbvie Inc. was the largest of 3 companies reporting payments in 2025, $442.80 in all, mostly food and beverage. Lists Long Island Jewish Medical Center and 2 other hospitals as hospital affiliations.
Overview
| NPI | 1194407999 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Aug 2, 2023 |
| Last updated in NPPES | Aug 2, 2023 |
| Certified by provider | Jul 14, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | 030197 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (NY) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 65 |
|---|---|
| Services billed | 145 across 7 procedure codes |
| Paid by Medicare | $12,777 |
Part D prescriptions in 2024
| Prescriptions (claims) | 251 · 476 30-day fills |
|---|---|
| Patients | 103 |
| Total drug cost | $39,491 |
| Generic share | 84% of claims |
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- North Shore-Lij Medical PCStaten Island, NY · 6,440 clinicians
Hospital affiliations
- Long Island Jewish Medical CenterNew Hyde Park, NY
- North Shore University HospitalManhasset, NY
- Ns/Lij Hs Southside HospitalBay Shore, NY
Industry payments (Open Payments)
- 2025$442.80 · 18 payments from 3 companies
- 2024$27.52 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Abbvie Inc. | $310.03 | 16 |
| Pfizer Inc. | $114.16 | 1 |
| Lundbeck LLC | $18.61 | 1 |
What the 2025 payments were for
- Food and Beverage$442.80 · 18 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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