Individual provider Active NPI

Mary Ann V Miranda, MD

  • Allergy & Immunology (Internal Medicine) Physician
  • Harker Heights, TX
National Provider Identifier
1972536597
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
License
N5247 Issued in TX
Practice address
2025 Memory LN Ste 400a
Harker Heights, TX 76548-7488
Phone
(254) 435-4995
Fax
(254) 432-5952
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25323 OK
Allergy & Immunology (Internal Medicine) Physician 207RA0201X N5247 TX Primary

Addresses

Primary practice location

2025 Memory LN Ste 400a
Harker Heights, TX 76548-7488

Mailing address

303 W Main St
Round Rock, TX 78664-5246
Phone (512) 732-2774

Other practice location 1

2027 S 61st St Ste 108
Temple, TX 76504-6856
Phone (254) 773-8916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, WY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070213000611 OK Practitioner - HospitalistPractitioner - Internal Medicine 3870597222 Reassigns benefits to 1 organization
I20251203002585 WY Practitioner - Internal Medicine 3870597222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

469 Hwy 50
Gillette, WY 82718-9330
Phone (307) 387-9850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N5247TXMDAllergy & Immunology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoskinson Health & Wellness Clinic LLC Internal Medicine CurrentSince Sep 29, 2025 Accepting new patients
St. John Physicians, Inc CurrentSince May 24, 2019 Accepting new patients
Hoskinson Health & Wellness Clinic LLC CurrentSince Sep 29, 2025 Accepting new patients
St. John Physicians, Inc. Internal Medicine CurrentSince May 24, 2019 Accepting new patients
Inpatient Consultants of Texas, PLLC Internal Medicine Past Accepting new patients
Paul Scibielski MD PA PastSince Jun 26, 2024 Accepting new patients

Locations

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

469 Wyoming Highway 50
Gillette, WY 82718
Phone (307) 387-9850

Interoperability endpoints

  • Direct secure messaging: mmiranda742571@direct.hopkinsmedicine.org
  • FHIR API: https://api.platform.athenahealth.com/26742/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mary.ann.miranda.1@26742.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1972536597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W MAIN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786645246",
            "telephone_number": "512-732-2774",
            "fax_number": "512-344-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 MEMORY LN STE 400A",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765487488",
            "telephone_number": "254-435-4995",
            "fax_number": "254-432-5952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2027 S 61st St Ste 108",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765046856",
            "country_code": "US",
            "telephone_number": "254-773-8916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "MARY ANN",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "25323",
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "TX",
            "license": "N5247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harker Heights, TX

Sources for this page

Verify at the official NPI Registry.