Individual provider Active NPI

Mariam Mir, M.D.

  • Internal Medicine Physician
  • Scranton, PA
National Provider Identifier
1376074864
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101270078 Issued in VA
Practice address
501 Madison Ave
Scranton, PA 18510-2401
Phone
(570) 343-2383
NPI assigned
Mar 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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
Internal Medicine Physician 207R00000X 0101270078 VA Primary

Addresses

Primary practice location

501 Madison Ave
Scranton, PA 18510-2401

Mailing address

501 Madison Ave
Scranton, PA 18510-2401
Phone (570) 343-2383

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
I20201103000759 VA Practitioner - Internal Medicine 2466722038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Virginia LLCGroup PAC ID 5698842235, 76 clinicians

Practice addresses (Care Compare)

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000

759 S Main St
Woodstock, VA 22664-1127
Phone (540) 459-1285

Hospital & facility affiliations

  • Winchester Medical Center Hospital, Winchester, VA, CCN 490005

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Fredericksburg, LLC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Hospitalist Medicine Physicians of Virginia LLC Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Winchester Medical Center Past Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

8260 Atlee Rd
Mechanicsvlle, VA 23116
Phone (804) 264-6000

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1376074864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102401",
            "telephone_number": "570-343-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102401",
            "telephone_number": "570-343-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIR",
        "first_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-25",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101270078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.