Active NPI
Eloiza Miranda, LMSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1104649987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 123876
- Practice address
- 1475 Park Ave
New York, NY 10029-3810 - Phone
- (212) 426-3400
- NPI assigned
- Nov 1, 2024
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 123876 | NY | Primary |
Addresses
Primary practice location
1475 Park Ave
New York, NY 10029-3810
Mailing address
1475 Park Ave
New York, NY 10029-3810
Other practice location 1
499 W 133rd St
New York, NY 10027-7404
Phone (646) 830-0655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123876 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northside Center for Child Development Day School | Past | Accepting new patients | |
| Northside Center for Child Development, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Local Education Agency (LEA)
- New York, NY
- NPI 1477882322
-
- Community/Behavioral Health Agency
- New York, NY
- NPI 1396817003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741651200000",
"number": "1104649987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1475 PARK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100293810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 PARK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100293810",
"telephone_number": "212-426-3400"
}
],
"practiceLocations": [
{
"address_1": "499 W 133rd St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100277404",
"country_code": "US",
"telephone_number": "646-830-0655",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRANDA",
"first_name": "ELOIZA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-01",
"last_updated": "2025-03-11",
"certification_date": "2025-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "123876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.