Active NPI
Joseph R Miranda, MD
- Diagnostic Radiology Physician
- Wichita, KS
National Provider Identifier
1568499358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 22240
- Practice address
- 3600 E Harry St
Wichita, KS 67218-3713 - Phone
- (316) 689-5050
- Fax
- (316) 689-6192
- NPI assigned
- Jun 27, 2006
- Last updated
- May 16, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 22240 | KS | Primary |
Addresses
Primary practice location
3600 E Harry St
Wichita, KS 67218-3713
Mailing address
PO Box 645
Wichita, KS 67201-0645
Phone (316) 689-5050
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16908 | Other | KS | COVENTRY |
| 1209 | Other | KS | PHS |
| 12149471 | Other | KS | MULTIPLAN |
| 100141070C | Medicaid | KS | |
| 018205 | Other | KS | BCBS |
| 200136 | Other | KS | HPK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22240 | KS | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400198400000",
"number": "1568499358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 645",
"city": "WICHITA",
"state": "KS",
"postal_code": "672010645",
"telephone_number": "316-689-5050",
"fax_number": "316-689-6192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 E HARRY ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672183713",
"telephone_number": "316-689-5050",
"fax_number": "316-689-6192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "JOSEPH",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2014-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "KS",
"license": "22240",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "16908",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS",
"identifier": "1209",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "12149471",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100141070C",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "018205",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPK",
"identifier": "200136",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.