Individual provider Active NPI

Miranda Nicole Martinez, PA

  • Physician Assistant
  • Pharr, TX
National Provider Identifier
1588033922
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
114 W Cherokee Ave
Pharr, TX 78577-4725
Phone
(956) 752-3909
Fax
(956) 295-3141
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

114 W Cherokee Ave
Pharr, TX 78577-4725

Mailing address

114 W Cherokee Ave
Pharr, TX 78577-4725
Phone (956) 752-3909

Other practice location 1

122 W Champion St
Edinburg, TX 78539-4429
Phone (956) 287-1207

Other practice location 2

1900 S Jackson Rd Ste 1
McAllen, TX 78503-1589
Phone (956) 340-4222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160120000516 TX Practitioner - Physician Assistant 0941503205 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Direct Care Pharr CurrentSince Apr 27, 2025 Accepting new patients

Locations

114 W Cherokee Ave
Pharr, TX 78577
Phone (956) 666-1854

Organizations & group practices 3

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1588033922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W CHEROKEE AVE",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785774725",
            "telephone_number": "956-752-3909",
            "fax_number": "956-295-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W CHEROKEE AVE",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785774725",
            "telephone_number": "956-752-3909",
            "fax_number": "956-295-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 W Champion St",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785394429",
            "country_code": "US",
            "telephone_number": "956-287-1207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 S Jackson Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785031589",
            "country_code": "US",
            "telephone_number": "956-340-4222",
            "fax_number": "956-307-3234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MIRANDA",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pharr, TX

Sources for this page

Verify at the official NPI Registry.