Individual provider Active NPI

Fernando E Miranda Sr., M.D. , P. A. ,

  • Surgery Physician
  • Pasadena, TX
National Provider Identifier
1205879822
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L6528 Issued in TX
Practice address
4301B Vista Rd
#100
Pasadena, TX 77504-2117
Phone
(713) 960-0590
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X L6528 TX Primary

Addresses

Primary practice location

4301B Vista Rd
#100
Pasadena, TX 77504-2117

Mailing address

PO Box 205732
Dallas, TX 75320-5732
Phone (713) 960-0590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041025000754 TX Practitioner - General Surgery 9133180912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Pennsylvania State University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Medical GroupGroup PAC ID 7012008360, 760 clinicians

Practice addresses (Care Compare)

11800 Astoria Blvd
Houston, TX 77089-6041
Phone (281) 929-6259

11920 Astoria Blvd
Suite 350
Houston, TX 77089-6155
Phone (281) 929-4420

16100 S Fwy
Pearland, TX 77584-1895
Phone (713) 413-6941

16100 S Fwy N3 172
Pearland, TX 77584-1895
Phone (713) 413-5738

3203 Broadway St
Pearland, TX 77581-1414
Phone (281) 485-8876

915 Gessner Rd
Suite 100
Houston, TX 77024-2537
Phone (713) 242-2222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
L6528TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Medical Group Surgery CurrentSince Apr 24, 2023 Accepting new patients

Locations

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

11920 Astoria Blvd
Ste 350
Houston, TX 77089
Phone (281) 929-4420

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

Interoperability endpoints

  • Direct secure messaging: fmiranda66330@memorialhermann.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1205879822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 205732",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753205732",
            "telephone_number": "713-960-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301B VISTA RD",
            "address_2": "#100",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775042117",
            "telephone_number": "713-960-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "FERNANDO",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D. , P. A. ,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L6528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.