Active NPI
Johnny Miranda, B.A
- Counselor
- Springfield, MA
National Provider Identifier
1669801023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2155 Main St
Springfield, MA 01104-3301 - Phone
- (413) 736-0395
- Fax
- (413) 734-1651
- NPI assigned
- Nov 6, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
2155 Main St
Springfield, MA 01104-3301
Mailing address
147 Norman St
West Springfield, MA 01089-5003
Phone (413) 736-8329
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042622756 | Other | MA | COMMONWEALTH CARE ALLIANCE |
| 1307576 | Other | MA | MBHP |
| 12529 | Other | MA | HEALTH NEW ENGLAND |
| 1307576 | Medicaid | MA | |
| 8443 | Other | MA | BMC |
| 1022610 | Other | MA | NHP |
| 1022610 | Other | MA | FALLON |
| 997203 | Other | MA | NETWORK HEALTH |
| Y10086 | Other | MA | MEDICARE |
| 1022610 | Other | MA | BEACON/BMC |
| 71756 | Other | MA | TUFTS |
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
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gandara Mental Health Center | Counselor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Counselor
- Springfield, MA
- NPI 1740723436
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1669801023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 NORMAN ST",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "010895003",
"telephone_number": "413-736-8329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2155 MAIN ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011043301",
"telephone_number": "413-736-0395",
"fax_number": "413-734-1651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "JOHNNY",
"credential": "B.A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-06",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMONWEALTH CARE ALLIANCE",
"identifier": "042622756",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBHP",
"identifier": "1307576",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NEW ENGLAND",
"identifier": "12529",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1307576",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC",
"identifier": "8443",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "1022610",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "1022610",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "997203",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "Y10086",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON/BMC",
"identifier": "1022610",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "71756",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.