Individual provider Active NPI

Mishell D Miranda, RDN

  • Registered Dietitian
  • Bronx, NY
National Provider Identifier
1124821376
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
012654 Issued in NY
Practice address
1650 Grand Concourse
Bronx, NY 10457-7679
Phone
(718) 992-7669
NPI assigned
Mar 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 012654 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457-7679

Mailing address

1276 Fulton Ave
Bronx, NY 10456-3467
Phone (718) 992-7669

Other names 1

  • Mrs. Mishell D Miranda Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250528001915 NY Practitioner - Registered Dietitian Or Nutrition Professional 7315466885 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012654NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Dietitian, Registered CurrentSince Apr 4, 2025 Accepting new patients
Bronxcare Health System CurrentSince Apr 4, 2025 Accepting new patients
Bronxcare Health System Current Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

Organizations & group practices 3

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": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1124821376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563467",
            "telephone_number": "718-992-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577679",
            "telephone_number": "718-992-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "MISHELL",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "012654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISHELL",
            "last_name": "MIRANDA",
            "middle_name": "D",
            "prefix": "MRS.",
            "credential": "REGISTERED DIETITIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.