Active NPI
Jerrald Epan Miranda, DPT
- Physical Therapist
- San Francisco, CA
National Provider Identifier
1336914084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 305102
- Practice address
- 302 Silver Ave
San Francisco, CA 94112-1510 - Phone
- (415) 334-2500
- NPI assigned
- Nov 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 305102 | CA | Primary |
Addresses
Primary practice location
302 Silver Ave
San Francisco, CA 94112-1510
Mailing address
650 Paris St
San Francisco, CA 94112-3512
Phone (415) 845-7255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305102 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1336914084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 PARIS ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941123512",
"telephone_number": "415-845-7255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 SILVER AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941121510",
"telephone_number": "415-334-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "JERRALD",
"middle_name": "EPAN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-21",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "305102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.