Individual provider Active NPI

Edward P. Miranda, M.D.

  • Plastic Surgery Physician
  • San Francisco, CA
National Provider Identifier
1710946868
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A82349 Issued in CA
Practice address
77 Van Ness Avenue
Suite 302
San Francisco, CA 94102
Phone
(415) 379-9015
Fax
(415) 379-9045
NPI assigned
Mar 18, 2006
Last updated
Sep 28, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 232599 NY
Plastic Surgery Physician 208200000X A82349 CA Primary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X A82349 CA
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X 232599 NY
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X A82349 CA
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 232599 NY
Surgery Physician 208600000X A82349 CA
Surgery Physician 208600000X 232599 NY
Surgery of the Hand (Surgery) Physician 2086S0105X A82349 CA
Surgery of the Hand (Surgery) Physician 2086S0105X 232599 NY
Plastic and Reconstructive Surgery Physician 2086S0122X 232599 NY
Plastic and Reconstructive Surgery Physician 2086S0122X A82349 CA
General Practice Physician 208D00000X A82349 CA
General Practice Physician 208D00000X 232599 NY
Legal Medicine (M.D./D.O.) Physician 209800000X A82349 CA

Addresses

Primary practice location

77 Van Ness Avenue
Suite 302
San Francisco, CA 94102

Mailing address

77 Van Ness Avenue
Suite 302
San Francisco, CA 94102
Phone (415) 379-9015

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
I20071219000524 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 7214027861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
JS Weill Medical College, Cornell University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward P Miranda MD a Medical CorporationGroup PAC ID 0244311975, 2 clinicians

Practice addresses (Care Compare)

77 Van Ness Ave
Apt 302
San Francisco, CA 94102-6042
Phone (415) 379-9015

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A82349CAMDPlastic Surgery Physician
232599NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward P. Miranda MD a Medical Corporation Plastic Surgery CurrentSince Jul 1, 2007 Accepting new patients
Pacific Specialist Surgical Center LLC Current Accepting new patients

Locations

77 Van Ness Ave
Apt 301
San Francisco, CA 94102
Phone (415) 821-8015

77 Van Ness Ave
Apt 302
San Francisco, CA 94102
Phone (415) 379-9015

Interoperability endpoints

  • Direct secure messaging: emiranda183755@hisp.ehr.sutterhealth.org

Organizations & group practices 2

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 2

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": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1710946868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 VAN NESS AVENUE",
            "address_2": "SUITE 302",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94102",
            "telephone_number": "415-379-9015",
            "fax_number": "415-379-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 VAN NESS AVENUE",
            "address_2": "SUITE 302",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94102",
            "telephone_number": "415-379-9015",
            "fax_number": "415-379-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "EDWARD",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "232599",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A82349",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "CA",
            "license": "A82349",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NY",
            "license": "232599",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "CA",
            "license": "A82349",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "232599",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A82349",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "232599",
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "CA",
            "license": "A82349",
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "232599",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "232599",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A82349",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A82349",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "232599",
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "A82349",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.