Miranda Dianne Ballard, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95029217 Issued in CA

Practice address

215 W Janss Rd
Thousand Oaks, CA 91360-1847

Phone

(805) 370-4435

NPI assigned

Feb 26, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Team Physicians of California Medical Group IncGroup PAC ID 8224945084, 92 clinicians

Synergy Observation Specialists PCGroup PAC ID 5496138307, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Team Physicians of California Medical Group Inc

  • Emergency Medicine Physician
  • Delano, CA
  • NPI 1447288345

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Synergy Observation Specialists PC

  • Emergency Medicine Physician
  • Simi Valley, CA
  • NPI 1023773587
  Medicare reassignment Care Compare group
• Los Robles Emergency Physicians Medical Group

  • Emergency Medicine Physician
  • Thousand Oaks, CA
  • NPI 1417983552
  Medicare reassignment NPD
• Sondermind Professional Clinical Counselor, PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1598629362
  Medicare reassignment

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1144086109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 VANGUARD DR",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102132",
            "telephone_number": "805-233-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W JANSS RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601847",
            "telephone_number": "805-370-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "MIRANDA",
        "middle_name": "DIANNE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95029217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Bakalian, NP
• Erin Elizabeth Baker
• Jamie Baker
• Lawrence Arthur Baker, M.D.
• Danette Balen-Garcia, M.A., LMFT (#24798)
• Destinee Cynthia Ballesteros
• Kaylie M Balvaneda
• Bamshad Dental Corporation
• Roya Banaie
• Kristina Banaitis, LCSW

• Nurse Practitioner in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.

Verify at the official NPI Registry.