Individual provider Active NPI

Rafael Manuel Miranda, DC

  • Chiropractor
  • Villalba, PR
National Provider Identifier
1578264271
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
908 Issued in PR
Practice address
Urb. Las Alondras Calle 1
A10
Villalba, PR 00766-2301
Phone
(787) 486-7919
NPI assigned
Mar 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 908 PR Primary

Addresses

Primary practice location

Urb. Las Alondras Calle 1
A10
Villalba, PR 00766-2301

Mailing address

Urb. Las Alondras Calle 1
A10
Villalba, PR 00766-2301
Phone (787) 486-7919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230803003776 PR Practitioner - Chiropractic 6406217686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1228 Ave Munoz Rivera
Suite 1
Ponce, PR 00717-0639
Phone (939) 500-0649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Spine Chiropractic LLC Chiropractor CurrentSince Jul 1, 2023 Accepting new patients
Modern Spine Chiropractic LLC PastSince Mar 12, 2023 Accepting new patients

Locations

1228 Ave Munoz Rivera
Ste 1
Ponce, PR 00717
Phone (787) 842-9122

Organizations & group practices 2

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": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1578264271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. LAS ALONDRAS CALLE 1",
            "address_2": "A10",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007662301",
            "telephone_number": "787-486-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. LAS ALONDRAS CALLE 1",
            "address_2": "A10",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007662301",
            "telephone_number": "787-486-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "RAFAEL",
        "middle_name": "MANUEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villalba, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.