Individual provider Active NPI

Thomas Benjamin De Miranda, M.D.

  • Interventional Pain Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1689866725
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
E-6411 Issued in AR
Practice address
2707 Market Trce
Fort Smith, AR 72908-8694
Phone
(479) 434-3600
Fax
(833) 992-0797
NPI assigned
Aug 13, 2007
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-6411 AR
Family Medicine Physician 207Q00000X 27166 OK
Interventional Pain Medicine Physician 208VP0014X E-6411 AR Primary

Addresses

Primary practice location

2707 Market Trce
Fort Smith, AR 72908-8694

Mailing address

2707 Market Trce
Fort Smith, AR 72908-8694
Phone (479) 434-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100624000874 AR Practitioner - Interventional Pain ManagementPractitioner - Family Practice 4981735636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain Management
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TBD Health Enterprises of Arkansas PLLCGroup PAC ID 1951845163, 4 clinicians

Practice addresses (Care Compare)

2707 Market Trce
Fort Smith, AR 72908-8694
Phone (479) 434-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-6411ARMDFamily Medicine Physician
27166OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brett Whatcott DO PLLC Interventional Pain Medicine CurrentSince Mar 1, 2024 Accepting new patients
TBD Health Enterprises of Arkansas PLLC Interventional Pain Medicine CurrentSince Mar 24, 2024 Accepting new patients
TBD Health Enterprises of Arkansas PLLC Interventional Pain Medicine Past Accepting new patients

Locations

2707 Market Trce
Fort Smith, AR 72908
Phone (479) 434-3600

302 N Greenwood Ave
Fort Smith, AR 72901
Phone (479) 434-3600

5320 W Sunset Ave
Ste 157B
Springdale, AR 72762
Phone (479) 434-3600

Interoperability endpoints

  • Direct secure messaging: thomas.benjamin.de.miranda.1@22374.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 1

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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1689866725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 MARKET TRCE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088694",
            "telephone_number": "479-434-3600",
            "fax_number": "833-992-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 MARKET TRCE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088694",
            "telephone_number": "479-434-3600",
            "fax_number": "833-992-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MIRANDA",
        "first_name": "THOMAS",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-6411",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "27166",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AR",
            "license": "E-6411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.