Organization Active NPI

Luis G. Miranda, M.D., P.C.

  • Urology Physician
  • Staten Island, NY
National Provider Identifier
1568746014
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
LUIS G. MIRANDA, M.D., P.C.
Practice address
11 Ralph PL
Suite 202
Staten Island, NY 10304-4401
Phone
(718) 448-1555
Fax
(718) 448-3950
NPI assigned
Oct 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Dr. Luis G. Miranda
Title
President
Phone
(718) 448-1555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

11 Ralph PL
Suite 202
Staten Island, NY 10304-4401

Mailing address

11 Ralph PL
Suite 202
Staten Island, NY 10304-4401
Phone (718) 448-1555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1568746014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "address_2": "SUITE 202",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044401",
            "telephone_number": "718-448-1555",
            "fax_number": "718-448-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "address_2": "SUITE 202",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044401",
            "telephone_number": "718-448-1555",
            "fax_number": "718-448-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS G. MIRANDA, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-448-1555",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.