Individual provider Active NPI

Gabriel Miranda, M.D.

  • Family Medicine Physician
  • Fremont, CA
National Provider Identifier
1952377756
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A038721 Issued in CA
Practice address
34167 Fremont Blvd
Fremont, CA 94555-2230
Phone
(510) 790-6315
NPI assigned
Feb 23, 2006
Last updated
Jul 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A038721 CA Primary

Addresses

Primary practice location

34167 Fremont Blvd
Fremont, CA 94555-2230

Mailing address

34167 Fremont Blvd
Fremont, CA 94555-2230
Phone (510) 790-6315

Other identifiers 3

IdentifierTypeStateIssuer
00A387212MedicaidCA
A0387210OtherCABLUE SHIELD PROVIDER NUM.
A038721OtherCAOTHER PRIVATE INS.PROV.NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20101221000946 CA Practitioner - Family Practice 3678761426 Practice locations: Fremont, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Medicine and Surgery, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

34167 Fremont Blvd
Fremont, CA 94555-2230
Phone (910) 790-6315

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A038721CAMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: gmiranda13708@direct.whhs.com

Hospital & facility affiliations 2

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1952377756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34167 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945552230",
            "telephone_number": "510-790-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34167 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945552230",
            "telephone_number": "510-790-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A038721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A387212",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUM.",
            "identifier": "A0387210",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER PRIVATE INS.PROV.NO",
            "identifier": "A038721",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.