Active NPI
Miranda Gruenberg, PA-C
- Physician Assistant
- Avondale, AZ
National Provider Identifier
1841444734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4329
- Practice address
- 13055 W McDowell Rd
Suite E-106
Avondale, AZ 85392-6449 - Phone
- (623) 975-8400
- NPI assigned
- Nov 5, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4329 | AZ | Primary |
Addresses
Primary practice location
13055 W McDowell Rd
Suite E-106
Avondale, AZ 85392-6449
Mailing address
13055 W McDowell Rd
Suite E-106
Avondale, AZ 85392-6449
Phone (623) 975-8400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13055 W McDowell Rd
Suite E106
Avondale, AZ 85392-6457
Phone (623) 975-8400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4329 | AZ | MD | Dentist |
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.
-
- Internal Medicine Physician
- Avondale, AZ
- NPI 1326145608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433721600000",
"number": "1841444734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13055 W MCDOWELL RD",
"address_2": "SUITE E-106",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853926449",
"telephone_number": "623-975-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13055 W MCDOWELL RD",
"address_2": "SUITE E-106",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853926449",
"telephone_number": "623-975-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUENBERG",
"first_name": "MIRANDA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-05",
"last_updated": "2015-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "4329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.