Individual provider Active NPI

Jose Rene Miranda, M.D.

  • Emergency Medicine Physician
  • Saint Helena, CA
National Provider Identifier
1508840513
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
CAG46935 Issued in CA
Practice address
10 Woodland Rd
Saint Helena, CA 94574-9554
Phone
(707) 963-3611
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X CAG46935 CA Primary

Addresses

Primary practice location

10 Woodland Rd
Saint Helena, CA 94574-9554

Mailing address

10 Woodland Rd
Saint Helena, CA 94574-9554
Phone (707) 963-3611

Other identifiers 1

IdentifierTypeStateIssuer
CAG46935OtherCASTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040604000356 CA Practitioner - Emergency Medicine 3476535246 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CAG46935CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Francisco Emergency Medical Associates Emergency Medicine CurrentSince Nov 1, 2012 Accepting new patients

Locations

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

45 Castro St
San Francisco, CA 94114
Phone (415) 241-5695

3325 Chanate Rd
Santa Rosa, CA 95404
Phone (707) 576-4000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508840513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "707-963-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "707-963-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JOSE",
        "middle_name": "RENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "CAG46935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "CAG46935",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helena, CA

Sources for this page

Verify at the official NPI Registry.