Individual provider Active NPI

Eloiza Miranda, LMSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1104649987
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
123876 Issued in NY
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

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
123876NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Center for Child Development Day School PastSince Mar 20, 2025 Accepting new patients
Northside Center for Child Development, Inc. PastSince Mar 20, 2025 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.

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.

Verify at the official NPI Registry.