Individual provider Active NPI

Miranda Nicole Lopez, DPT

  • Physical Therapist
  • Orange, CA
National Provider Identifier
1649924648
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301679 Issued in CA
Practice address
2854 N Santiago Blvd Ste 100
Orange, CA 92867-1700
Phone
(714) 771-7047
NPI assigned
Feb 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 301679 CA Primary
Physical Therapist 225100000X

Addresses

Primary practice location

2854 N Santiago Blvd Ste 100
Orange, CA 92867-1700

Mailing address

700 W Walnut Ave Apt 60
Orange, CA 92868-2249
Phone (714) 400-5628

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220322003163 CA Practitioner - Physical Therapist in Private Practice 0042605362 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.86 of 100Reported as group
Quality
82.51
Improvement activities
40
Cost
52.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
301679CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Therapy Solutions Physical Therapist CurrentSince Jan 4, 2023 Accepting new patients
Mariners Physical Therapy, Inc. Physical Therapist CurrentSince Jun 5, 2023 Accepting new patients
John M. Somerndike Physical Therapy, PC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
California Therapy Solutions CurrentSince Jan 4, 2023 Accepting new patients

Locations

485 E 17th St
Ste 650
Costa Mesa, CA 92627
Phone (949) 722-7374

18682 Beach Blvd
Ste 130
Huntington Beach, CA 92648
Phone (714) 963-6600

2854 N Santiago Blvd
Ste 100
Orange, CA 92867
Phone (714) 771-7047

201 Sandpointe Ave
Ste 130
Santa Ana, CA 92707
Phone (714) 557-9292

Organizations & group practices 4

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": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1649924648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W WALNUT AVE APT 60",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682249",
            "telephone_number": "714-400-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2854 N SANTIAGO BLVD STE 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928671700",
            "telephone_number": "714-771-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MIRANDA",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301679",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.