Active NPI
Carlos Gustavo Teran Miranda, M.D
- Pediatrics Physician
- Merced, CA
National Provider Identifier
1649526765
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jun 20, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A119549
- Practice address
- 847 W Childs Ave
Merced, CA 95341-6862 - Phone
- (209) 383-7441
- Fax
- (209) 383-7813
- NPI assigned
- Jul 26, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35. 099330 | OH | |
| Pediatrics Physician | 208000000X | A119549 | CA | Primary |
Addresses
Primary practice location
847 W Childs Ave
Merced, CA 95341-6862
Mailing address
737 W Childs Ave
Merced, CA 95341-6805
Phone (209) 383-1848
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A119549 | Other | CA | CA MEDICAL LICENSE |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35. 099330 | OH | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362528000000",
"number": "1649526765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "737 W CHILDS AVE",
"city": "MERCED",
"state": "CA",
"postal_code": "953416805",
"telephone_number": "209-383-1848",
"fax_number": "209-383-1296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "847 W CHILDS AVE",
"city": "MERCED",
"state": "CA",
"postal_code": "953416862",
"telephone_number": "209-383-7441",
"fax_number": "209-383-7813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERAN MIRANDA",
"first_name": "CARLOS",
"middle_name": "GUSTAVO",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-26",
"last_updated": "2013-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35. 099330",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A119549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA MEDICAL LICENSE",
"identifier": "A119549",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Merced, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.