Individual provider Active NPI

Josue A Miranda, M.D.

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1821038555
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101034998 Issued in VA
Practice address
5136 Princess Anne Rd
Virginia Beach, VA 23462-4228
Phone
(757) 473-0003
Fax
(757) 497-9510
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101034998 VA Primary

Addresses

Primary practice location

5136 Princess Anne Rd
Virginia Beach, VA 23462-4228

Mailing address

5136 Princess Anne Rd
Virginia Beach, VA 23462-4228
Phone (757) 473-0003

Other identifiers 1

IdentifierTypeStateIssuer
73-20256MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20101007000519 VA Practitioner - General Practice 2961694039

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
22.04 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kempsville Primary Medical Care Center Inc CurrentSince Jul 31, 1992 Accepting new patients

Locations

5136 Fletchers Arch
Virginia Beach, VA 23462
Phone (757) 473-0003

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1821038555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5136 PRINCESS ANNE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624228",
            "telephone_number": "757-473-0003",
            "fax_number": "757-497-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5136 PRINCESS ANNE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624228",
            "telephone_number": "757-473-0003",
            "fax_number": "757-497-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JOSUE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101034998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73-20256",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.