JOSE LUIS MIRA JR. M.D.
NPI 1669823118
Internal Medicine in Fredericksburg, VA

Q: What is Jose Mira's NPI number?

The NPI number for Jose Mira is 1669823118. It was assigned to this individual provider in the NPPES registry on June 27, 2016.

Q: What is Jose Mira's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Jose Mira was last updated on January 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 27, 2016PECOS EnrolledAccepts Medicare Assignment

1201 HOSPITAL DR, FREDERICKSBURG, VA 22401(540) 368-3700 Get Directions Write a Review

NPPES record last updated: January 10, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 10, 2022, Jun 27, 2016 (2 updates tracked since 2016).

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About Jose Luis Mira Jr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOSE LUIS MIRA JR. M.D. (NPI 1669823118) is an individual internal medicine provider in Fredericksburg, Virginia, licensed in Virginia (0101266677) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, maintains a secondary practice location in Charleston, and is a graduate of Morehouse School Of Medicine (2016).

NPPES Registry Identity

NPI1669823118

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameJOSE LUIS MIRA JR.Credential: M.D.

Location Address1201 HOSPITAL DRFredericksburg, VA 22401-8428

Mailing Address8328 E Harrison CtFredericksburg, VA 22407-1906

Phone(540) 368-3700

Sole ProprietorYes

Medical School CMSMorehouse School Of MedicineGraduated 2016

Enumeration DateJune 27, 2016

Last NPPES UpdateJanuary 10, 20222 updates tracked since enumeration

NPPES CertifiedJune 21, 2021

✔ NPI 1669823118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in VA · 0101266677

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1201 HOSPITAL DR, Fredericksburg, VA 22401

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Secondary Practice Location 1

Location 1169 Ashley Ave, Room 202 Main Hospital, MSC333Charleston, SC 29425-8905 · Phone (843) 792-2911

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jose Luis Mira Jr. M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204114432

PECOS Enrollment IDI20191104000811, I20210616000385

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jose Mira reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc

26 mi

Health Maintenance Organization

13285 MINNIEVILLE ROAD
Woodbridge, VA 22192

Reassigned Medicare billing, Virginia and District of Columbia enrollments
Also billed through NPI 1215058326 (District of Columbia)
995 clinicians in this Medicare group

NPI 1972275196 (301) 816-2424

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

48 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$129.04 typical visit price

range $56.19 – $170.30

Typical copayment $32.26 (range $14.04 – $42.57)

Most-billed visit code 99204

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JESSICA NOMM PHARMD, RPH

Pharmacist (Ambulatory Care)