Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Imran Ahmed Mridha, PA

Individual provider Physician Assistant · NPI 1558970558

Imran Ahmed Mridha, PA is a Physician Assistant in Fairfield, Connecticut. Qualified in 2020, 6 years ago. Practices with Pain and Spine Specialists of Connecticut LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
6
Licensed in
CT
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

75 Kings Highway Cutoff Ste 3A
Fairfield, CT 06824-5340
Phone: (203) 743-7264
Fax: (203) 792-3920
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5039 (CT)

Record details

NPI number1558970558
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 24, 2020
Last updated in NPPESMarch 7, 2022
Certification dateMarch 7, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Pain And Spine Specialists Of Connecticut Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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