Organization Active NPI

Amalia M Miranda MD PLLC

  • Ophthalmology Physician
  • Oklahoma City, OK
National Provider Identifier
1194951657
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD16074 Issued in OK
Legal business name
AMALIA M MIRANDA MD PLLC
Practice address
3435 NW 56TH St Ste 700
Oklahoma City, OK 73112-4442
Phone
(405) 921-8571
Fax
(405) 945-4748
NPI assigned
Jun 10, 2009
Last updated
Jun 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Authorized official

Name
Dr. Amalia M Miranda, M.D.NPI 1942272372
Title
Owner
Phone
(405) 921-8571

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD16074 OK Primary

Addresses

Primary practice location

3435 NW 56TH St Ste 700
Oklahoma City, OK 73112-4442

Mailing address

3435 NW 56TH St Ste 700
Oklahoma City, OK 73112-4442
Phone (405) 921-8571

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090701000072 OK Part B Supplier - Clinic/Group Practice 5698826766 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1194951657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 NW 56TH ST STE 700",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124442",
            "telephone_number": "405-921-8571",
            "fax_number": "405-945-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 NW 56TH ST STE 700",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124442",
            "telephone_number": "405-921-8571",
            "fax_number": "405-945-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMALIA M MIRANDA MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-10",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "AMALIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-921-8571",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "MD16074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.