Individual provider Active NPI

Miranda Kay Woodward, PA-C

  • Physician Assistant
  • Cranberry TWP, PA
National Provider Identifier
1871320010
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA065934 Issued in PA
Practice address
213 Executive Dr Ste 200
Cranberry TWP, PA 16066-6405
Phone
(724) 741-0044
NPI assigned
Sep 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA006999 PA
Physician Assistant 363A00000X MA065934 PA Primary

Addresses

Primary practice location

213 Executive Dr Ste 200
Cranberry TWP, PA 16066-6405

Mailing address

13120 Club House Rd
Presto, PA 15142-1598
Phone (262) 422-1994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241010000461 PA Practitioner - Physician Assistant 0840722252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians
Genesis Medical Associates, Inc.Group PAC ID 7113814104, 99 clinicians

Practice addresses (Care Compare)

203 High Pointe Dr
Suite 100
Seven Fields, PA 16046-7921
Phone (724) 742-1250

3601 McKnight E Dr
Pittsburgh, PA 15237-6400
Phone (412) 369-9943

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA065934PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Associates, Inc. CurrentSince Sep 30, 2024 Accepting new patients

Locations

213 Executive Dr
Ste 200
Cranberry Twp, PA 16066
Phone (724) 741-0044

8150 Perry Hwy
Ste 201
Pittsburgh, PA 15237
Phone (412) 369-9550

3601 McKnight East Dr
Pittsburgh, PA 15237
Phone (412) 369-9943

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.

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": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1871320010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13120 CLUB HOUSE RD",
            "city": "PRESTO",
            "state": "PA",
            "postal_code": "151421598",
            "telephone_number": "262-422-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 EXECUTIVE DR STE 200",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160666405",
            "telephone_number": "724-741-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "MIRANDA",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA006999",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry TWP, PA

Sources for this page

Verify at the official NPI Registry.