Individual provider Active NPI

Annie L Miranda, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Hopewell Junction, NY
National Provider Identifier
1851345102
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
210185 Issued in NY
Practice address
1989 Route 52
Suite 3
Hopewell Junction, NY 12533-3533
Phone
(845) 897-4500
Fax
(845) 897-4550
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 210185 NY Primary

Addresses

Primary practice location

1989 Route 52
Suite 3
Hopewell Junction, NY 12533-3533

Mailing address

1989 Route 52
Suite 3
Hopewell Junction, NY 12533-3533
Phone (845) 897-4500

Other identifiers 1

IdentifierTypeStateIssuer
01990692MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210185NYMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PM Pediatrics of Bayside, PLLC Past Accepting new patients
Night Lite Pediatric Center, LLC Past Accepting new patients
PM Pediatrics PC Past Accepting new patients
Express Pediatrics: Walk in Urgent Care for Children, PLLC Past Accepting new patients

Organizations & group practices 4

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1851345102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1989 ROUTE 52",
            "address_2": "SUITE 3",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125333533",
            "telephone_number": "845-897-4500",
            "fax_number": "845-897-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1989 ROUTE 52",
            "address_2": "SUITE 3",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125333533",
            "telephone_number": "845-897-4500",
            "fax_number": "845-897-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "ANNIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "210185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01990692",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell Junction, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.