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

MS. Mia Lauren Ryckman, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1417591348

MS. Mia Lauren Ryckman, PHYSICIANASSISTANT is a Physician Assistant in Chandler, Arizona. Qualified in 2019, 7 years ago. Practices with Southeast Valley Gastroenterology Consultants, PC, a 32-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
7
Licensed in
AZ
In the registry since
2019
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Practice location Address checks out

875 S Dobson Rd
Chandler, AZ 85224-5710
Phone: (480) 899-9800
Fax: (480) 899-2994
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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 7560 (AZ)

Record details

NPI number1417591348
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedNovember 4, 2019
Last updated in NPPESNovember 4, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Southeast Valley Gastroenterology Consultants, P.C. — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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