Individual provider Active NPI

Hernan E Miranda, MD

  • Internal Medicine Physician
  • Amarillo, TX
National Provider Identifier
1477547339
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N0984 Issued in TX
Practice address
1215 S Coulter St
Suite 104
Amarillo, TX 79106-1758
Phone
(806) 350-7355
Fax
(806) 350-7362
NPI assigned
Sep 7, 2005
Last updated
Mar 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N0984 TX Primary

Addresses

Primary practice location

1215 S Coulter St
Suite 104
Amarillo, TX 79106-1758

Mailing address

1215 S Coulter St
Suite 104
Amarillo, TX 79106-1758
Phone (806) 350-7355

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
I20081101000101 TX Practitioner - Internal MedicinePractitioner - Emergency Medicine 7719945633 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC CurrentSince Oct 14, 2016 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jan 3, 2017 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Oct 14, 2016 Accepting new patients
Grove Inpatient Services Internal Medicine Past Accepting new patients
Executive Health Resources Clinical Staffing Solutions PC Internal Medicine Past Accepting new patients
Upshur Emergency Medicine Associates PA Past Accepting new patients
East Texas Medical Center-Gilmer Past Accepting new patients
Wood Emergency Medicine Associates PA Past Accepting new patients
Clinical Staffing Solutions P.C. Internal Medicine Past Accepting new patients
East Texas Medical Center Gilmer Past Accepting new patients
Virtua Medical Group, PA Internal Medicine Past Accepting new patients
Hera Inpatient Services Internal Medicine Past Accepting new patients
Atlantic Professional Services of Rhode Island Incorporated Past Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1477547339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 S COULTER ST",
            "address_2": "SUITE 104",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061758",
            "telephone_number": "806-350-7355",
            "fax_number": "806-350-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 S COULTER ST",
            "address_2": "SUITE 104",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061758",
            "telephone_number": "806-350-7355",
            "fax_number": "806-350-7362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "HERNAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N0984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.