Individual provider Active NPI

Mia Ridgway, PA-C

  • Physician Assistant
  • Cortlandt Manor, NY
National Provider Identifier
1760378616
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone
(914) 737-9000
NPI assigned
Jun 17, 2025
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144

Mailing address

7 Cary Rd
Hyde Park, NY 12538-2619
Phone (845) 264-4247

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
I20251104000544 NY Practitioner - Physician Assistant 7810487493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Association of New York PCGroup PAC ID 8426952813, 35 clinicians

Practice addresses (Care Compare)

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034506NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Association of New York PC Physician Assistant CurrentSince Oct 20, 2025 Accepting new patients

Locations

1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1760378616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARY RD",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125382619",
            "telephone_number": "845-264-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 CROMPOND RD",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105674144",
            "telephone_number": "914-737-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGWAY",
        "first_name": "MIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortlandt Manor, NY

Sources for this page

Verify at the official NPI Registry.