Individual provider Active NPI

Maryanne S Miranda

  • Registered Nurse
  • Jersey City, NJ
National Provider Identifier
1992045645
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
26NR14519200 Issued in NJ
Practice address
377 Jersey Ave
Jersey City, NJ 07302-4393
Phone
(201) 499-3897
NPI assigned
Feb 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR14519200 NJ Primary

Addresses

Primary practice location

377 Jersey Ave
Jersey City, NJ 07302-4393

Mailing address

436 Fairmount Ave
Jersey City, NJ 07306-5910
Phone (201) 616-2379

Other identifiers 1

IdentifierTypeStateIssuer
35-2321534OtherNJLUTHERAN SENIOR LIFE AT JERSEY CITY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26NR14519200NJMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1992045645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 FAIRMOUNT AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065910",
            "telephone_number": "201-616-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 JERSEY AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024393",
            "telephone_number": "201-499-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "MARYANNE",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR14519200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LUTHERAN SENIOR LIFE AT JERSEY CITY",
            "identifier": "35-2321534",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.