Individual provider Active NPI

Marvi Miranda, M.D.

  • General Practice Physician
  • Delhi, CA
National Provider Identifier
1609265602
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A143356 Issued in CA
Practice address
9696 Stephens St
Delhi, CA 95315-9550
Phone
(209) 667-0702
Fax
(209) 667-6737
NPI assigned
Jan 13, 2015
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
General Practice Physician 208D00000X A143356 CA Primary

Addresses

Primary practice location

9696 Stephens St
Delhi, CA 95315-9550

Mailing address

PO Box 3768
Merced, CA 95344-3768
Phone (209) 725-7149

Other practice location 1

3605 Hospital Rd
Atwater, CA 95301-5173
Phone (209) 723-3704

Other practice location 2

374 W Olive Ave Ste A
Merced, CA 95348-3181
Phone (209) 384-5766

Other practice location 3

1675 Shaffer Rd
Atwater, CA 95301-4456
Phone (209) 383-5500

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address marvi.miranda.1@3012.direct.athenahealth.com Direct
Direct Messaging Address marvi.miranda.1@3012.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160825002665 CA Practitioner - Family Practice 5294020517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1675 Shaffer Rd
Atwater, CA 95301-4456
Phone (209) 383-5500

9696 Stephens St
Delhi, CA 95315-9550
Phone (209) 667-0702

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A143356CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Merced Faculty Associates Medical Group, Incorporated CurrentSince Jul 11, 2016 Accepting new patients
Merced Faculty Associates Medical Group Incorporated Current Accepting new patients
Dignity Health Past Accepting new patients

Locations

1675 Shaffer Rd
Atwater, CA 95301
Phone (209) 357-5121

3605 Hospital Rd
Atwater, CA 95301
Phone (209) 381-2000

9696 Stephens St
Delhi, CA 95315
Phone (209) 667-0702

374 W Olive Ave
Ste A
Merced, CA 95348
Phone (209) 205-1001

535 W 25th St
Merced, CA 95340
Phone (209) 722-9066

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3012/brand/1/csg/1/fhir/r4
  • Direct secure messaging: marvi.miranda.1@3012.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1609265602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3768",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953443768",
            "telephone_number": "209-725-7149",
            "fax_number": "209-726-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9696 STEPHENS ST",
            "city": "DELHI",
            "state": "CA",
            "postal_code": "953159550",
            "telephone_number": "209-667-0702",
            "fax_number": "209-667-6737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3605 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Atwater",
            "state": "CA",
            "postal_code": "953015173",
            "country_code": "US",
            "telephone_number": "209-723-3704",
            "fax_number": "209-723-0272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "374 W Olive Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953483181",
            "country_code": "US",
            "telephone_number": "209-384-5766",
            "fax_number": "209-383-4230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1675 Shaffer Rd",
            "address_purpose": "LOCATION",
            "city": "Atwater",
            "state": "CA",
            "postal_code": "953014456",
            "country_code": "US",
            "telephone_number": "209-383-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "MARVI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-13",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A143356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marvi.miranda.1@3012.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1675 Shaffer Rd",
            "city": "Atwater",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953014456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marvi.miranda.1@3012.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9696 Stephens St",
            "city": "Delhi",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953159550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Delhi, CA

Sources for this page

Verify at the official NPI Registry.