Patrick James Miranda, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC6134 Issued in FL

Practice address

1050 Old Camp Rd
The Villages, FL 32162-1762

Phone

(352) 350-8484

NPI assigned

Jul 1, 2022

Last updated

Apr 11, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes at the Villages PAGroup PAC ID 5294987905, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: patrick.miranda.p3@direct.stlukeseye.nextgenshare.com

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.

• St . Lukes at the Villages, PA

  • Ophthalmology Physician
  • The Villages, FL
  • NPI 1801144217

  Optometrist

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1871226324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43309 US HIGHWAY 19 N",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346896221",
            "telephone_number": "727-938-2020",
            "fax_number": "727-938-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 OLD CAMP RD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321621762",
            "telephone_number": "352-350-8484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2955 Brownwood Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321632040",
            "country_code": "US",
            "telephone_number": "352-626-1450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "PATRICK",
        "middle_name": "JAMES",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-01",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115197100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry L Miller, LMT
• Mary Beth Miller, MD
• Roger Miller, PHD
• Mind and Brain Clinical Services, LLC
• Miracle-Ear
• Loren Mirsky Piatkin
• Vinod R Miryala, MD
• Raymond J Mis
• Mmelbarry (Foot Solutions)
• David Lawerence Modders, PHD

• Optometrist in The Villages, FL
• Providers in The Villages, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.

Verify at the official NPI Registry.