Individual provider Active NPI

Fernando G Miranda, MD

  • Specialist
  • Vero Beach, FL
National Provider Identifier
1033144134
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0043449 Issued in FL
Practice address
2801 Ocean Dr Ste 202
Vero Beach, FL 32963-2025
Phone
(772) 231-1155
Fax
(722) 231-1177
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0043449 FL Primary

Addresses

Primary practice location

2801 Ocean Dr Ste 202
Vero Beach, FL 32963-2025

Mailing address

2801 Ocean Dr Ste 202
Vero Beach, FL 32963-2025
Phone (772) 231-1155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA, OK3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050707000200 FL Practitioner - Neurology 1557266228 Practice locations: Vero Beach, FL
I20100803001237 CA Practitioner - Neurology 1557266228 Practice locations: San Francisco, CA
I20120821000507 OK Practitioner - NeurologyPractitioner - PsychiatryPractitioner - Neuropsychiatry 1557266228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Neuropsychiatry, Psychiatry
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1145 S Utica Ave
Suite 901
Tulsa, OK 74104-4005
Phone (918) 742-0400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30680CAMDClinical Psychologist
ME0043449FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurolinks of Tulsa, LLC CurrentSince Jun 24, 2012 Accepting new patients
Polaris Neuroscience Institute LLC Specialist Past Accepting new patients
MCT Associates Inc. Specialist Past Accepting new patients
Indian River Primary Care Specialist PastSince Mar 9, 1998 Accepting new patients

Locations

1145 S Utica Ave
Ste 901
Tulsa, OK 74104
Phone (918) 392-7071

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AACBDD/Endpoint/AACBDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/HECFAD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1033144134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 OCEAN DR STE 202",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329632025",
            "telephone_number": "772-231-1155",
            "fax_number": "722-231-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 OCEAN DR STE 202",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329632025",
            "telephone_number": "772-231-1155",
            "fax_number": "722-231-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "FERNANDO",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0043449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.