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

Miranda Basto, PAC

Individual provider Physician Assistant · NPI 1538965256

Miranda Basto, PAC is a Physician Assistant in Lawrenceville, Georgia. Qualified in 2025, 1 year ago. Accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
1
Licensed in
GA
In the registry since
2025
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

1900 Riverside Pkwy
Lawrenceville, GA 30043-5925
Phone: (770) 237-3475
Fax: (770) 237-3756
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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 13251 (GA)

Record details

NPI number1538965256
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedFebruary 22, 2025
Last updated in NPPESJuly 25, 2025
Certification dateJuly 25, 2025
Mailing address1900 Riverside Pkwy, Lawrenceville, GA 30043-5925

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)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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