Active NPI
Natalie Miranda
- Physician Assistant
- Boston, MA
National Provider Identifier
1033722822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA7781
- Practice address
- 55 Fruit St # Street1
Boston, MA 02114-2696 - Phone
- (617) 643-0045
- Fax
- (617) 726-7415
- NPI assigned
- Aug 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA7781 | MA | Primary |
Addresses
Primary practice location
55 Fruit St # Street1
Boston, MA 02114-2696
Mailing address
35 Henshaw St
Brighton, MA 02135-2927
Phone (860) 483-1633
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Park Ave
FL 11
New York, NY 10016-5803
700 Hicksville Rd
Bethpage, NY 11714-3471
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA7781 | MA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts General Physicians Organization Inc | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
55 Fruit St
Boston, MA 02114
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
55 Fruit St
#1
Boston, MA 02114
Phone (617) 724-4100
Interoperability endpoints
- nmiranda734916@nyumc.direct-ci.com
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.
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611792000000",
"number": "1033722822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 HENSHAW ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352927",
"telephone_number": "860-483-1633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST # STREET1",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142696",
"telephone_number": "617-643-0045",
"fax_number": "617-726-7415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "NATALIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-31",
"last_updated": "2021-01-28",
"certification_date": "2021-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA7781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.