Individual provider Active NPI

Justin A Miranda, M.D.

  • Pediatric Anesthesiology Physician
  • Houston, TX
National Provider Identifier
1356697965
Registry record updated Feb 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
R1832 Issued in TX
Practice address
6431 Fannin St
MSB 5.020
Houston, TX 77030-1501
Phone
(713) 500-6200
Fax
(713) 500-6208
NPI assigned
Aug 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Anesthesiology Physician 207LP3000X R1832 TX Primary

Addresses

Primary practice location

6431 Fannin St
MSB 5.020
Houston, TX 77030-1501

Mailing address

6431 Fannin St
MSB 5.020
Houston, TX 77030-1501
Phone (713) 500-6200

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
I20170717003572 TX Practitioner - Anesthesiology 4183994650 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
U. S. Anesthesia Partners of Texas, P.a., CurrentSince Sep 3, 2019 Accepting new patients
Tejas Anesthesia PLLC CurrentSince Feb 18, 2019 Accepting new patients
Tejas Anesthesia PLLC Pediatric Anesthesiology CurrentSince Feb 18, 2019 Accepting new patients
U S Anesthesia Partners of Texas, PA CurrentSince Sep 3, 2019 Accepting new patients

Locations

6431 Fannin St
#5020
Houston, TX 77030
Phone (713) 500-6200

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

4242 Medical Dr
Ste 3100
San Antonio, TX 78229
Phone (210) 477-9555

10999 W Interstate 10
Ste 903
San Antonio, TX 78230
Phone (210) 375-7790

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Organizations & group practices 4

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": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488067200000",
    "number": "1356697965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "MSB 5.020",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6200",
            "fax_number": "713-500-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "MSB 5.020",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6200",
            "fax_number": "713-500-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JUSTIN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2017-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "R1832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.