Roberto Miranda, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E2740 Issued in TX

Practice address

1508 Dessau Ridge LN Apt 602
Ste B
Austin, TX 78754-2121

Phone

(512) 477-9202

Fax

(512) 472-9473

NPI assigned

May 24, 2005

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 2

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Roberto Miranda, MD PA

  • Family Medicine Physician
  • Austin, TX
  • NPI 1457598690
  NPD (past) Authorized official

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1891798633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 DESSAU RIDGE LN APT 602",
            "address_2": "STE B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787542121",
            "telephone_number": "512-477-9202",
            "fax_number": "512-472-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 DESSAU RIDGE LN APT 602",
            "address_2": "STE B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787542121",
            "telephone_number": "512-477-9202",
            "fax_number": "512-472-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E2740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00318Q",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140282837",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Miracle, DC
• Neda Miraki, APRN, FNP-C
• Cynthia Miranda, MD
• Lori Axler Miranda, LMSW
• Mary Ann Marcella Miranda, APRN, AHCNS-BC
• Anisty Mirasol
• Sarah Paige Mire, SLP-CF
• Mariel Mireles Contreras, BCBA
• Mireles Family Therapy PLLC
• Joleen Mireles-Hutchens, LPC

• Family Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.