Dennis Borja Miranda, PT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

11134024 Issued in WI

Practice address

311 W Kalsched St
Apt. 209
Marshfield, WI 54449-1466

Phone

(715) 383-0102

NPI assigned

May 14, 2009

Sex

Male

Sole proprietor

Yes

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 IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Fox Rehabilitation Services Il LLC

  • Physical Therapist
  • Westchester, IL
  • NPI 1114443462

  Geriatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242259200000",
    "number": "1285868513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W KALSCHED ST",
            "address_2": "APT. 209",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491466",
            "telephone_number": "715-383-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W KALSCHED ST",
            "address_2": "APT. 209",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491466",
            "telephone_number": "715-383-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "DENNIS",
        "middle_name": "BORJA",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-14",
        "last_updated": "2009-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WI",
            "license": "11134024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Noon A a Mohamed, MD

• Geriatric Physical Therapist in Marshfield, WI
• Providers in Marshfield, WI by specialty
• Geriatric Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.