Individual provider Active NPI

Joanna Miranda, OD

  • Optometrist
  • Montclair, CA
National Provider Identifier
1720561483
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34026TLG Issued in CA
Practice address
5237 Arrow Hwy
Montclair, CA 91763-1308
Phone
(909) 625-6567
NPI assigned
Sep 10, 2018
Last updated
May 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34026 CA
Optometrist 152W00000X 34026TLG CA Primary

Addresses

Primary practice location

5237 Arrow Hwy
Montclair, CA 91763-1308

Mailing address

5237 Arrow Hwy
Montclair, CA 91763-1308
Phone (909) 625-6567

Other practice location 1

17150 Gale Ave
City Of Industry, CA 91745-1809
Phone (626) 804-1405

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025003503 CA Practitioner - Optometry 0446695571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5237 Arrow Hwy
Montclair, CA 91763-1308
Phone (909) 625-6567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34026CAMDOptometrist
34026TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Joanna Miranda OD Inc Optometrist CurrentSince Sep 1, 2024 Accepting new patients

Locations

5237 Arrow Hwy
Montclair, CA 91763
Phone (909) 347-7722

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1720561483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5237 ARROW HWY",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631308",
            "telephone_number": "909-625-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5237 ARROW HWY",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631308",
            "telephone_number": "909-625-6567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17150 Gale Ave",
            "address_purpose": "LOCATION",
            "city": "City Of Industry",
            "state": "CA",
            "postal_code": "917451809",
            "country_code": "US",
            "telephone_number": "626-804-1405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JOANNA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34026",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34026TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

Verify at the official NPI Registry.