MIRANDA MCCORMACK, M.D., LLC
NPI 1043488166
Clinic/Center - Primary Care in Beaverton, OR
About Miranda Mccormack, M.d., Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MIRANDA MCCORMACK, M.D., LLC (NPI 1043488166) is a healthcare organization registered as a primary care in Beaverton, Oregon and active in the NPI registry since February 2008. The organization holds a CLIA Waiver certificate valid through January 14, 2028 and lists Miranda Christie Mccormack, Physician/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Miranda Mccormack, M.d., Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Miranda Mccormack, M.D., LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 38D1078738
Miranda Mccormack MD LLC · Beaverton, ORFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Miranda Mccormack, M.D., LLC's NPI number?
The NPI number for Miranda Mccormack, M.D., LLC is 1043488166. It was assigned to this organization in the NPPES registry on February 11, 2008.
Where is Miranda Mccormack, M.D., LLC located?
Miranda Mccormack, M.D., LLC is located at 5040 SW Griffith Dr #201, Beaverton, OR 97005. The listed phone number is (503) 616-2224.
What is Miranda Mccormack, M.D., LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Miranda Mccormack, M.D., LLC enrolled in Medicare?
Yes. Miranda Mccormack, M.D., LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Miranda Mccormack, M.D., LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Miranda Mccormack, M.D., LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Miranda Mccormack, M.D., LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 38D1078738) is associated with this NPI, valid through January 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Miranda Mccormack, M.D., LLC was last updated on February 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Miranda Mccormack, M.d., Llc · NPI 1043488166
Primary Care organization in Beaverton, Oregon. Organization record, active in the CMS NPPES registry since February 11, 2008.
## Identity
- **NPI:** 1043488166 (Entity type: Organization)
- **Enumerated:** February 11, 2008
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Miranda Mccormack, PHYSICIAN/OWNER
## Practice location
- **Address:** 5040 SW GRIFFITH DR, #201, Beaverton, OR 97005-2985
- **Phone:** (503) 616-2224
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 11, 2008
- **Other identifiers:** Medicare UPIN H73664 (OR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1043488166) · Data from the CMS NPPES public registry.