Individual provider Active NPI

Mira Maya Tamang, NP

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1437958519
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1182426 Issued in TX
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

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
928784OtherTXRN LICENSE
1182426OtherTXNURSES 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321003599 TX Practitioner - Nurse Practitioner 2163944836 Reassigns benefits to 1 organization

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
Dallas Nephrology AssociatesGroup PAC ID 3870403819, 156 clinicians

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

LicenseStateTypeSpecialty
1182426TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Nephrology Associates CurrentSince Apr 14, 2025 Accepting new patients
Dallas Nephrology Associates CurrentSince Apr 14, 2025 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

  • FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: 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.

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": "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

Verify at the official NPI Registry.