Melissa Miranda
Physician Assistant in Roseville, CA. Individual provider (NPI-1).
NPI number1336717560
StatusActive
Last updated in NPPESMay 3, 2022
Details
- NPI
- 1336717560
- Entity type
- Individual (NPI-1)
- Name
- Melissa Miranda
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 14, 2021
- Certification date
- May 3, 2022
- Last updated
- May 3, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA60089 | CA | Yes |
| 363A00000X | Physician Assistant | PA9114146 | FL | |
| 363AM0700X | Physician Assistant, Medical | PA9114146 | FL | |
| 363AM0700X | Physician Assistant, Medical | PA60089 | CA | |
| 363AS0400X | Physician Assistant, Surgical | PA60089 | CA | |
| 363AS0400X | Physician Assistant, Surgical | PA9114146 | FL |
Practice location
729 Sunrise Ave Ste 900Roseville, CA 95661-4525
Phone 916-781-3310
Mailing address
729 Sunrise Ave Ste 900Roseville, CA 95661-4525
Phone 916-781-3310
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 85 Physician Assistant providers in Roseville · All 6,478 providers in Roseville
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