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

Individual provider Physician Assistant · NPI 1033324645

Miyasari Ranoewidjojo, PAC is a Physician Assistant in Hackensack, New Jersey. Graduated from State University of New York Downstate Medical Center in 2002, 24 years ago. Practices with Hackensack Meridian Health Medical Group - Primary Care PC, a 364-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
24
Trained at
State University of New York Downstate Medical Center
Licensed in
NJ
In the registry since
2007
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

30 Prospect Ave Hackensack University Medical Ctr
Hackensack, NJ 07601-1914
Phone: (201) 996-4614
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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 25MP00118300 (NJ)

Record details

NPI number1033324645
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedMay 14, 2007
Last updated in NPPESDecember 13, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSTATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduated 2002 (24 years in practice)
Group practice Hackensack Meridian Health Medical Group - Primary Care Pc — 364 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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