DR. PAUL A MIRANDA MD
NPI 1285659144
Family Medicine in Jasper, TN
NPI Status: Active since July 13, 2006
- Individual
- Male
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About PAUL MIRANDA
This page provides the complete NPI Profile along with additional information for Paul Miranda, a primary care provider established in Jasper, Tennessee with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1285659144 assigned on July 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 34164 (TN). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1285659144
- Provider Name
- DR. PAUL A MIRANDA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1000 TN-28 JASPER, TN 37347
- Location Phone
- (423) 837-3400
- Mailing Address
- 2589 BRISTLECONE LN SIGNAL MOUNTAIN, TN 37377
- Mailing Phone
- (423) 243-8196
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-13-2006
- Last Update Date
- 05-15-2024
- Code Navigator
A primary care provider (PCP) like Paul Miranda sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 34164
- License State
- TN
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | MD034164 (TN) |
| 2 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | 70270 (GA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCross B07S HSA - EPO
- BlueCross B15S $0 virtual care from Teladoc Health � - EPO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross B17S $0 virtual care from Teladoc Health � + Adult Dental - EPO
- BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S29S $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Secure - EPO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Simple Breathe Easy with Enhanced COPD Benefits - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4352656 | OTHER (01) | TN | BCBS - TENNESSEE |
| 1508291 | MEDICAID (05) | TN |
Medicare Participation & PECOS Enrollment Status
Paul Miranda is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 21 Medicare Claims 22 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Advance care planning, first 30 minutes
Annual depression screening, 15 minutes
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month
Emergency department visit for life threatening or functioning severity
Emergency department visit for problem of high severity
Emergency department visit for problem of moderate severity
Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a
Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
This service was performed 31 times for 31 patientsAn annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
This service was performed 27 times for 27 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 60 times for 60 patientsChronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
This service was performed 159 times for 101 patientsChronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
This service was performed 600 times for 246 patientsComplex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.
This service was performed 88 times for 41 patientsComplex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.
This service was performed 69 times for 55 patientsAn emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
This service was performed 168 times for 155 patientsAn emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
This service was performed 70 times for 69 patientsAn emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
This service was performed 54 times for 48 patientsThis is a routine visit for established patients residing in care facilities like nursing homes or assisted living. The visit typically lasts about 40 minutes, during which the healthcare provider checks your overall health, discusses any concerns, and adjusts care plans as needed.
This service was performed 24 times for 23 patientsThis service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
This service was performed 18 times for 15 patientsThis service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
This service was performed 57 times for 38 patientsThis is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
This service was performed 185 times for 141 patientsThis procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
This service was performed 175 times for 90 patientsRemote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.
This service was performed 13 times for 12 patientsThis service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
This service was performed 34 times for 27 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 37347 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $81.53
- Minimum New Patient Price $52.64
- Maximum New Patient Price $160.89
- Average New Patient Copayment $20.38
- Minimum New Patient Copayment $13.16
- Maximum New Patient Copayment $40.22
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.6
- Minimum Established Patient Price $16.72
- Maximum Established Patient Price $131.41
- Average Established Patient Copayment $23.4
- Minimum Established Patient Copayment $4.18
- Maximum Established Patient Copayment $32.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Care Plan | 58% | 31 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 8 | 5 | 6 | 5 | 9 | 1 | 4 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 16 | 5 | 12 | 5 | 18 | 1 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 6 + 5 + 1 + 2 + 5 + 1 + 8 + 1 + 8 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1285659144 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1336569359 | KEVIN STEVENS MD Individual | Emergency Medicine | 1000 TN-28 JASPER, TN 37347 (423) 837-3400 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285659144, enumerated in the NPI registry as an "individual" on July 13, 2006
The provider is located at 1000 Tn-28 Jasper, Tn 37347 and the phone number is (423) 837-3400
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, Oscar Insurance. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $81.53 with an average copayment of $20.38 for new patient appointments. Established patients should expect a typical charge of $93.6 and an average copayment of 23.4. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Advance care planning, first 30 minutes, Annual depression screening, 15 minutes, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month, Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month, Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month, Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month, Emergency department visit for life threatening or functioning severity, Emergency department visit for problem of high severity, Emergency department visit for problem of moderate severity, Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes, Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes, Management using the results of remote vital sign monitoring per calendar month, first 20 minutes, Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and, Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a, Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment and Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days.
This NPI record was last updated on July 13, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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