Individual provider Active NPI

Nina F Miranda, RNCS/NP

  • Nurse Practitioner
  • Tewksbury, MA
National Provider Identifier
1831112580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
172831 Issued in MA
Practice address
365 East St
Tewksbury, MA 01876-1950
Phone
(978) 851-7321
Fax
(978) 858-3795
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

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
Nurse Practitioner 363L00000X 172831 MA Primary

Addresses

Primary practice location

365 East St
Tewksbury, MA 01876-1950

Mailing address

365 East St
Tewksbury, MA 01876-1950
Phone (978) 851-7321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051207000804 MA Practitioner - Nurse Practitioner 9739100678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

365 E St
Tewksbury, MA 01876-1950

365 E St
Tewksbury, MA 01876-1998
Phone (978) 851-7321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
172831MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Jan 1, 2006 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Jan 1, 2006 Accepting new patients

Locations

91 Crest Ave
Chelsea, MA 02150
Phone (617) 336-9508

365 East St
Tewksbury, MA 01876
Phone (617) 536-2186

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 and National Provider Directory roles.

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831112580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 EAST ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761950",
            "telephone_number": "978-851-7321",
            "fax_number": "978-858-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 EAST ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761950",
            "telephone_number": "978-851-7321",
            "fax_number": "978-858-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "NINA",
        "middle_name": "F",
        "credential": "RNCS/NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "172831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

Verify at the official NPI Registry.