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

Mia Leigh Carlson, MMSPA

Individual provider Physician Assistant · NPI 1639970080

Mia Leigh Carlson, MMSPA is a Physician Assistant in Englewood, New Jersey. Qualified in 2025, 1 year ago. Practices with Englewood Spine Associates LLC, a 2-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
1
Licensed in
NJ
In the registry since
2025
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Practice location Address checks out

300 Grand Ave Ste 201
Englewood, NJ 07631-6300
Phone: (201) 608-5656
Fax: (201) 608-5650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (NJ)

Record details

NPI number1639970080
Entity typeIndividual (Type 1)
GenderFemale
Credentials MMSPA
Sole proprietorNo
NPI enumeratedMarch 21, 2025
Last updated in NPPESJune 6, 2025
Certification dateJune 3, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Englewood Spine Associates Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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