Dr. Tamader H. Mira, P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DR. TAMADER H. MIRA, P.A.

Practice address

5505 Ritchie Hwy
E
Brooklyn, MD 21225-3444

Phone

(410) 355-0340

Fax

(410) 636-3403

NPI assigned

Feb 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Tamader Mira, M.D.NPI 1023205887

Title

President

Phone

(410) 440-4827

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDJDCD

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tamader H Mira, M.D.

  • Internal Medicine Physician
  • Brooklyn, MD
  • NPI 1023205887
  Medicare reassignment NPD Authorized official
• Daniella Villaran, DNP, FNP-C

  • Family Nurse Practitioner
  • Brooklyn, MD
  • NPI 1972231462
  Medicare reassignment NPD
• Letitia Jeanna Wright, MD

  • Internal Medicine Physician
  • Parkville, MD
  • NPI 1992987499

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640476800000",
    "number": "1508830829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 RITCHIE HWY",
            "address_2": "E",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "212253444",
            "telephone_number": "410-355-0340",
            "fax_number": "410-636-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 RITCHIE HWY",
            "address_2": "E",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "212253444",
            "telephone_number": "410-355-0340",
            "fax_number": "410-636-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. TAMADER H. MIRA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A",
        "authorized_official_last_name": "MIRA",
        "authorized_official_first_name": "TAMADER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-440-4827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "912081500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Brooklyn, MD
• Providers in Brooklyn, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.