Individual provider Active NPI

Ralph James Miranda, O.D.

  • Optometrist
  • Stockton, CA
National Provider Identifier
1730197807
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 7014 TPA Issued in CA
Practice address
5904 N El Dorado St
Suite G
Stockton, CA 95207-4467
Phone
(209) 473-2020
Fax
(209) 473-2176
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 7014 TPA CA Primary

Addresses

Primary practice location

5904 N El Dorado St
Suite G
Stockton, CA 95207-4467

Mailing address

5904 N El Dorado St
Suite G
Stockton, CA 95207-4467
Phone (209) 473-2020

Other identifiers 1

IdentifierTypeStateIssuer
SD0070140MedicaidCA

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
I20060906000546 CA Practitioner - Optometry 9436153376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zeiter Eye Medical Group IncGroup PAC ID 8527018316, 11 clinicians

Practice addresses (Care Compare)

255 E Weber Ave
Stockton, CA 95202-2706
Phone (209) 466-5566

Merit-based Incentive Payment System (MIPS)

Final score
85.63 of 100Reported as group
Quality
94
Improvement activities
40
Cost
43.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 7014 TPACAMDOptometrist

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730197807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 N EL DORADO ST",
            "address_2": "SUITE G",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952074467",
            "telephone_number": "209-473-2020",
            "fax_number": "209-473-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 N EL DORADO ST",
            "address_2": "SUITE G",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952074467",
            "telephone_number": "209-473-2020",
            "fax_number": "209-473-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "RALPH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 7014 TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0070140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.