Individual provider Active NPI

Graciany Miranda, MD.

  • Hematology & Oncology Physician
  • Humacao, PR
National Provider Identifier
1386639995
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
5558 Issued in PR
Practice address
Dufresne Street No.7
Humacao, PR 00791
Phone
(787) 852-5260
Fax
(787) 285-7958
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 5558 PR Primary

Addresses

Primary practice location

Dufresne Street No.7
Humacao, PR 00791

Mailing address

295 Palmas Inn Way
Suite 130 PMB 309
Humacao, PR 00791-6181
Phone (787) 852-5260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20060328000565 PR Practitioner - Hematology/OncologyPractitioner - Internal Medicine 0648288928 Practice locations: Humacao, PR

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

295 Palmas Inn Way
Suite 130 PMB 309
Humacao, PR 00791-6181

7 Dufresne Bajos
Humacao, PR 00791
Phone (787) 852-5260

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1386639995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 PALMAS INN WAY",
            "address_2": "SUITE 130 PMB 309",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007916181",
            "telephone_number": "787-852-5260",
            "fax_number": "787-285-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DUFRESNE STREET NO.7",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-852-5260",
            "fax_number": "787-285-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "GRACIANY",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PR",
            "license": "5558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.