Active NPI
Mira Maya Tamang, NP
- Nurse Practitioner
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1182426
- Practice address
- 3604 Live Oak St Ste 100
Dallas, TX 75204-6169 - Phone
- (214) 358-2300
- Fax
- (214) 579-6985
- NPI assigned
- Mar 11, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 1182426 | TX | |
| Nurse Practitioner | 363L00000X | 1182426 | TX | Primary |
Addresses
Primary practice location
3604 Live Oak St Ste 100
Dallas, TX 75204-6169
Mailing address
1505 LBJ Fwy Ste 700
Dallas, TX 75234-6065
Phone (214) 358-2300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 928784 | Other | TX | RN LICENSE |
| 1182426 | Other | TX | NURSES LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1625 N Story Rd
Suite 140
Irving, TX 75061-1954
Phone (972) 871-8282
3500 Gaston Ave
Dallas, TX 75246-2017
Phone (469) 801-4500
3604 Live Oak St
Suite 100
Dallas, TX 75204-6169
Phone (214) 358-2300
621 N Hall St
Dallas, TX 75226-1339
Phone (214) 820-0600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1182426 | TX | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dallas Nephrology Associates | Current | Accepting new patients | |
| Dallas Nephrology Associates | Current | Accepting new patients |
Locations
1150 N Bishop Ave
Ste 100
Dallas, TX 75208
Phone (214) 956-8200
3604 Live Oak St
Ste 100
Dallas, TX 75204
1505 Lyndon B Johnson Fwy
Ste 700
Dallas, TX 75234
Phone 21435823006012
Interoperability endpoints
- https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/
- mtamang75115@direct.acumenmd.com
Organizations & group practices 2
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.
-
- Nephrology Physician
- Dallas, TX
- NPI 1861440109
-
dba Dallas Nephrology Associates Vascular Center Dallas
- Ambulatory Surgical Clinic/Center
- Dallas, TX
- NPI 1053634030
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1447250253
-
dba Baylor Scott & White Heart and Vascular Hospital - Dallas
- General Acute Care Hospital
- Dallas, TX
- NPI 1609855139
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741910400000",
"number": "1437958519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 LBJ FWY STE 700",
"city": "DALLAS",
"state": "TX",
"postal_code": "752346065",
"telephone_number": "214-358-2300",
"fax_number": "214-579-6985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3604 LIVE OAK ST STE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752046169",
"telephone_number": "214-358-2300",
"fax_number": "214-579-6985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAMANG",
"first_name": "MIRA MAYA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-03-11",
"last_updated": "2025-03-14",
"certification_date": "2025-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "TX",
"license": "1182426",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "1182426",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "928784",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSES LICENSE",
"identifier": "1182426",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.