Individual provider Active NPI

Michael J. Miranda, D.C.

  • Chiropractor
  • Turnersville, NJ
National Provider Identifier
1992770622
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
NJMCO2573 Issued in NJ
Practice address
501 Route 168
Turnersville, NJ 08012-1458
Phone
(609) 410-9015
Fax
(856) 401-3122
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NJMCO2573 NJ Primary

Addresses

Primary practice location

501 Route 168
Turnersville, NJ 08012-1458

Mailing address

501 Route 168
Turnersville, NJ 08012-1458
Phone (609) 410-9015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050802000638 NJ Practitioner - Chiropractic 7911935762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3747 Church Rd
Suite 104a
Mount Laurel, NJ 08054-1151
Phone (609) 410-9015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NJMCO2573NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Future Chiropractic Center LLC Chiropractor CurrentSince Sep 23, 2012 Accepting new patients
Oliver Chiropractic Assoc P.a. Past Accepting new patients

Locations

3747 Church Rd
Ste 104A
Mount Laurel, NJ 08054
Phone (609) 410-9015

501 Route 168
Turnersville, NJ 08012
Phone (856) 374-1200

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.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1992770622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 ROUTE 168",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080121458",
            "telephone_number": "609-410-9015",
            "fax_number": "856-401-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ROUTE 168",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080121458",
            "telephone_number": "609-410-9015",
            "fax_number": "856-401-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "NJMCO2573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turnersville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.