Individual provider Active NPI

Mia Cao

  • Primary Care Nurse Practitioner
  • Havre de Grace, MD
National Provider Identifier
1417896119
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R243796 Issued in MD
Practice address
108 Bayland Dr Unit 21
Havre de Grace, MD 21078-4236
Phone
(929) 326-7531
NPI assigned
Mar 26, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X R243796 MD Primary

Addresses

Primary practice location

108 Bayland Dr Unit 21
Havre de Grace, MD 21078-4236

Mailing address

108 Bayland Dr Unit 21
Havre de Grace, MD 21078-4236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

108 Bayland Dr
Unit 21
Havre de Grace, MD 21078-4234

12321 Middlebrook Rd
Suite 102
Germantown, MD 20874-0505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R243796MDMDPrimary Care Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1774483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1417896119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BAYLAND DR UNIT 21",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210784236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 BAYLAND DR UNIT 21",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210784236",
            "telephone_number": "929-326-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAO",
        "first_name": "MIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-26",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R243796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

Verify at the official NPI Registry.