Roque Miramontes, PA, MPH

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005548 Issued in GA

Practice address

1600 Clifton Rd NE
Ms: E-10
Atlanta, GA 30329-4018

Phone

(404) 639-6306

Fax

(404) 929-2854

NPI assigned

Jun 12, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Roque Miramontes Jr. Other name

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1194952408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CLIFTON RD NE",
            "address_2": "MS: E-10",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294018",
            "telephone_number": "404-639-6306",
            "fax_number": "404-929-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CLIFTON RD NE",
            "address_2": "MS: E-10",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294018",
            "telephone_number": "404-639-6306",
            "fax_number": "404-929-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRAMONTES",
        "first_name": "ROQUE",
        "credential": "PA, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-12",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005548",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16051",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004457",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROQUE",
            "last_name": "MIRAMONTES",
            "suffix": "JR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mir Solutions Inc
• Miracle Caregivers for Needy Children Inc.
• Miracle Health Care Services
• Miracle Houses, Incorporated
• Miraculous Health & Rehabilitation
• Alexa N Miranda
• Titania W Miranda, MD
• Michelle Anne Mirando, LMSW
• Myriam Caridad Miras, D.M.D,
• Wednesday Mirbach

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.