Individual provider Active NPI

Mark F Miranda, MD

  • Internal Medicine Physician
  • Portsmouth, VA
National Provider Identifier
1285898171
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101243900 Issued in VA
Practice address
4725 Portsmouth Blvd
Portsmouth, VA 23701-2307
Phone
(757) 488-8888
NPI assigned
Jul 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101243900 VA Primary

Addresses

Primary practice location

4725 Portsmouth Blvd
Portsmouth, VA 23701-2307

Mailing address

4725 Portsmouth Blvd
Portsmouth, VA 23701-2307
Phone (757) 488-8888

Other practice location 1

7800 66th St N Ste 202
Pinellas Park, FL 33781-2101
Phone (727) 477-2988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20081125000517 VA Practitioner - Internal Medicine 0446310197 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients

Locations

155 Kingsley Ln
Ste 150
Norfolk, VA 23505
Phone (757) 278-2350

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

7007 Harbour View Blvd
Ste 108
Suffolk, VA 23435
Phone (757) 215-2784

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1285898171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 PORTSMOUTH BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237012307",
            "telephone_number": "757-488-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 PORTSMOUTH BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237012307",
            "telephone_number": "757-488-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7800 66th St N Ste 202",
            "address_purpose": "LOCATION",
            "city": "Pinellas Park",
            "state": "FL",
            "postal_code": "337812101",
            "country_code": "US",
            "telephone_number": "727-477-2988",
            "fax_number": "727-516-4788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "MARK",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101243900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.