Miranda Ring, FNP

Individual provider Active NPI Family Nurse Practitioner · Derby, NY

NPI 1962000307 · NPPES record last updated Sep 2, 2021

Key facts

NPI
1962000307
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
345507 (NY)
Practice address
7060 Erie Rd
Derby, NY 14047-9430
Phone
(716) 947-0408
NPI assigned
Oct 16, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210212000459 NY Practitioner - Nurse Practitioner 2365857984 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Family Medicine Assoc PC Current
since Jan 1, 2021
Accepting new patients
General Physician, PC Past
since Jan 1, 2021
Accepting new patients

Locations

7060 Erie Rd
Ste 100
Derby, NY 14047
Phone (716) 947-0408

7060 Erie Rd
Derby, NY 14047
Phone (716) 677-2273

10626 Main St
North Collins, NY 14111
Phone (716) 337-2422

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345507 NY Yes

Addresses

Primary practice location

7060 Erie Rd
Derby, NY 14047-9430

Mailing address

8672 Highland Dr
Eden, NY 14057-9502
Phone (845) 800-5114

Other providers in Derby, NY

All providers in Derby, NY · Family Nurse Practitioner in New York

Sources for this page

Verify at the official NPI Registry.