Individual provider Active NPI

Carmen Elena Miranda, CNP

  • Family Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1538677208
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.022167 Issued in OH
Practice address
1340 Belmont Ave Ste 2200
Youngstown, OH 44504
Phone
(307) 467-4003
Fax
(330) 746-7436
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.022167 OH Primary

Addresses

Primary practice location

1340 Belmont Ave Ste 2200
Youngstown, OH 44504

Mailing address

1340 Belmont Ave Ste 2200
Youngstown, OH 44504-1131
Phone (307) 467-4003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180913003084 OH Practitioner - Nurse Practitioner 1951651819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1053 Belmont Ave
Youngstown, OH 44504-1007
Phone (330) 480-2516

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.022167OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC Nurse Practitioner CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Sep 4, 2018 Accepting new patients
Mercy Health Physicians Youngstown, LLC Nurse Practitioner CurrentSince Sep 4, 2018 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

1053 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-3605

905 Sahara Trl
Youngstown, OH 44514
Phone (330) 726-0100

1340 Belmont Ave
Ste 2200
Youngstown, OH 44504
Phone (330) 480-7350

250 E Federal St
Fl 4
Youngstown, OH 44503
Phone (330) 884-7010

Interoperability endpoints

  • Direct secure messaging: cmiranda37211@direct.bsmhealth.org

Organizations & group practices 4

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 3

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1538677208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BELMONT AVE STE 2200",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041131",
            "telephone_number": "307-467-4003",
            "fax_number": "330-746-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BELMONT AVE STE 2200",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44504",
            "telephone_number": "307-467-4003",
            "fax_number": "330-746-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "CARMEN",
        "middle_name": "ELENA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.022167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.