Individual provider Active NPI

Mya Niccole Twyman, PA-C

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1750925343
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00554200 Issued in NJ
Practice address
3424 Kossuth Ave
Bronx, NY 10467-2410
Phone
(718) 519-3333
NPI assigned
Nov 6, 2019
Last updated
May 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00554200 NJ Primary
Physician Assistant 363A00000X PA63697 CA
Physician Assistant 363A00000X 6369 CT
Physician Assistant 363A00000X 024328 NY

Addresses

Primary practice location

3424 Kossuth Ave
Bronx, NY 10467-2410

Mailing address

240 Mulberry St FL 1
Newark, NJ 07102-3528
Phone (973) 622-3900

Other practice location 1

238 Mulberry St Fl 1
Newark, NJ 07102-3528
Phone (973) 622-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200320000983 NY Order and Referring Only - Physician Assistant 3173951480

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1400 Pelham Pkwy S
Bronx, NY 10461-1119

45 Research Way
Suite 206
East Setauket, NY 11733-6401

66 W Gilbert St
Tinton Falls, NJ 07701-4948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024328NYMDClinical Social Worker
PA63697CAMDPhysician Assistant
25MP00554200NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Metropolitan New Jersey Past Accepting new patients
Planned Parenthood of Metropolitan New Jersey Past Accepting new patients
Planned Parenthood of Metropolitan NJ Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mtwyman1169353@nychhc.direct-ci.com
  • Direct secure messaging: mya.twyman.p2@direct.bhplannedparenthood.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1750925343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MULBERRY ST FL 1",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071023528",
            "telephone_number": "973-622-3900",
            "fax_number": "973-644-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672410",
            "telephone_number": "718-519-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "238 Mulberry St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071023528",
            "country_code": "US",
            "telephone_number": "973-622-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TWYMAN",
        "first_name": "MYA",
        "middle_name": "NICCOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00554200",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63697",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "6369",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.