Individual provider Active NPI

Adelaida M Miro, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Miami, FL
National Provider Identifier
1861437709
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
MD168660 Issued in OR
Practice address
12720 SW 70TH LN
Miami, FL 33183-2453
Phone
(206) 465-8652
NPI assigned
Jun 17, 2006
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00038357 WA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD168660 OR Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME65347 FL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD039831L NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD00038357 WA
Pulmonary Disease Physician 207RP1001X ME65347 FL

Addresses

Primary practice location

12720 SW 70TH LN
Miami, FL 33183-2453

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-5111

Other identifiers 1

IdentifierTypeStateIssuer
8355158MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amiro153263@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OR, GU3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110425000368 PA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 1254321672 Reassigns benefits to 1 organization
I20160127002691 OR Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 1254321672 Reassigns benefits to 4 organizations
I20210901003443 GU Practitioner - Internal Medicine 1254321672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Charles Health System IncGroup PAC ID 3870402852, shared by 10 NPIs, 174 clinicians

Practice addresses (Care Compare)

1253 NW Canal Blvd
Redmond, OR 97756-1334
Phone (541) 548-8131

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 706-2768

384 SE Combs Flat Rd
Prineville, OR 97754-2562
Phone (541) 706-2768

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD039831LNCMDCritical Care Medicine (Internal Medicine) Physician
ME65347FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Mar 1, 2016 Accepting new patients
St. Charles Health System, Inc. CurrentSince Mar 1, 2016 Accepting new patients
Geisinger Clinic Critical Care Medicine CurrentSince Apr 1, 2011 Accepting new patients
Geisinger Clinic Current Accepting new patients
Guam Memorial Hospital CurrentSince May 19, 2021 Accepting new patients
Geisinger Clinic CurrentSince Apr 1, 2011 Accepting new patients
St. Charles Health System, Inc. CurrentSince Mar 1, 2016 Accepting new patients
St. Charles Health System, Inc. Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
Guam Memorial Hospital CurrentSince May 19, 2021 Accepting new patients
St. Charles Health System, Inc. Internal Medicine Current Accepting new patients
St. Charles Health System, Inc. Internal Medicine Past Accepting new patients
Primedoc of Randolph County PA Internal Medicine Past Accepting new patients

Locations

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

470 NE A St
Madras, OR 97741
Phone (541) 383-3668

384 SE Combs Flat Rd
Prineville, OR 97754
Phone (541) 383-3668

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

100 N Academy Ave
Danville, PA 17822

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Interoperability endpoints

  • Direct secure messaging: amiro153263@samhealth.direct-ci.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1861437709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 SW 70TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331832453",
            "telephone_number": "206-465-8652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-768-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRO",
        "first_name": "ADELAIDA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-03-15",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00038357",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD168660",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME65347",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "MD039831L",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD00038357",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME65347",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8355158",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amiro153263@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3600 NW Samaritan Dr",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.