Individual provider Active NPI

Yaoska Brasilia Miranda-Rosales, PA-C

  • Medical Physician Assistant
  • Atascocita, TX
National Provider Identifier
1306303441
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA13247 Issued in TX
Practice address
17903 W Lake Houston Pkwy Ste 101
Atascocita, TX 77346-3954
Phone
(215) 570-6856
NPI assigned
Feb 25, 2019
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA13247 TX Primary
Physician Assistant 363A00000X 9128 GA

Addresses

Primary practice location

17903 W Lake Houston Pkwy Ste 101
Atascocita, TX 77346-3954

Mailing address

17903 W Lake Houston Pkwy Ste 101
Atascocita, TX 77346-3954
Phone (215) 570-6856

Other practice location 1

4517 Kingwood Dr
Kingwood, TX 77345-2621
Phone (281) 547-7556

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200108000678 TX Practitioner - Physician Assistant 3072948660 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Carenow Urgent Care PLLCGroup PAC ID 7012291958, 113 clinicians
Providence Physician AssociatesGroup PAC ID 8022354638, 11 clinicians

Practice addresses (Care Compare)

102 W 11TH St
Houston, TX 77008-6857
Phone (835) 539-4707

10422 Research Forest Dr
Magnolia, TX 77354-6155
Phone (832) 702-7699

1150 W Dallas St
Conroe, TX 77301-2208
Phone (713) 955-4510

11845 N Grand Pkwy E
New Caney, TX 77357-1839
Phone (832) 432-6150

300 Northpark Dr
Kingwood, TX 77339-1672
Phone (281) 310-8445

3832 Atascocita Rd
Suite C
Humble, TX 77396-3533
Phone (281) 812-0578

4517 Kingwood Dr
Kingwood, TX 77345-2621
Phone (832) 831-9094

6306 Fairbanks N Houston Rd
Suite 500
Houston, TX 77040-5193
Phone (832) 831-9094

7306 Louetta Rd
Spring, TX 77379-6115
Phone (832) 271-5589

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9128GAMDPhysician Assistant
PA13247TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince Jun 27, 2022 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Jun 27, 2022 Accepting new patients
Southlake Doctors Express, PA PSC Current Accepting new patients
Brazos Medical Center Past Accepting new patients

Locations

17903 W Lake Houston Pkwy
Ste 101
Humble, TX 77346
Phone (215) 570-6856

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1306303441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17903 W LAKE HOUSTON PKWY STE 101",
            "city": "ATASCOCITA",
            "state": "TX",
            "postal_code": "773463954",
            "telephone_number": "215-570-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17903 W LAKE HOUSTON PKWY STE 101",
            "city": "ATASCOCITA",
            "state": "TX",
            "postal_code": "773463954",
            "telephone_number": "215-570-6856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4517 Kingwood Dr",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773452621",
            "country_code": "US",
            "telephone_number": "281-547-7556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA-ROSALES",
        "first_name": "YAOSKA",
        "middle_name": "BRASILIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA13247",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atascocita, TX

Sources for this page

Verify at the official NPI Registry.