Hernan E Miranda, MD

Individual provider Active NPI Internal Medicine Physician · Amarillo, TX

NPI 1477547339 · NPPES record last updated Mar 15, 2016

Key facts

NPI
1477547339
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
N0984 (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
Sex
Male
Sole proprietor
Yes

Organizations & group practices 14

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20081101000101 TX Practitioner - Internal Medicine
Practitioner - Emergency Medicine
7719945633 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

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

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

Specialties & licenses

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

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

Other providers in Amarillo, TX

All providers in Amarillo, TX · Internal Medicine Physician in Texas

Sources for this page

Verify at the official NPI Registry.