MIRANDA NICOLE EDWARDS (M.D.) – Pediatrics Physician, NPI 1215376710

MIRANDA NICOLE EDWARDS (M.D.) is a healthcare provider. based in Peoria, Illinois. specializing in PEDIATRIC MEDICINE. They hold the professional credentials M.D.. They hold a License No. 125.063393 (IL). The NPI Number for MIRANDA NICOLE EDWARDS (M.D.) is 1215376710

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
MIRANDA NICOLE EDWARDS (M.D.)
NPI
1215376710
Phone
(307) 349-7920
Address
530 NE GLEN OAK AVE
Enumeration Date
18 June 2013
Last Update Date
18 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9702982800
Graduation Year
2013 (13 years ago)
PAC ID
8426379272
Group Practice PAC ID
1557267069
Professional Enrollment ID
I20201229002088
Address ID
CO815068818GR2698XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:12State licenses:2Digital endpointsOther names

1,158 PEDIATRIC MEDICINE in IL

Provider Addresses for MIRANDA NICOLE EDWARDS (M.D.)

  • 530 NE GLEN OAK AVE

    PEORIA, IL 616370001

    Phone: (307) 349-7920

    Type: Mailing

  • 710 WELLINGTON AVE

    GRAND JUNCTION, CO 815016123

    Phone: (970) 298-6601

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-12-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201229002088IPediatric MedicineCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes13071$0
36415Insertion of needle into vein for collection of blood sample5845$0
99213Established patient office or other outpatient visit, 20-29 minutes5543$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit3434$0
99215Established patient office or other outpatient visit, 40-54 minutes2018$0
View full utilization report →

Insurance plans in this area (ZIP 61637)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557267069View full group profile

Reviews

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Frequently asked questions

What is the registry number for MIRANDA NICOLE EDWARDS (M.D.)?
The registry entry for MIRANDA NICOLE EDWARDS (M.D.) shows NPI 1215376710.
Is MIRANDA NICOLE EDWARDS (M.D.) currently accepting referrals based on NPI status?
Registry metadata lists MIRANDA NICOLE EDWARDS (M.D.) as active.
What does the directory say MIRANDA NICOLE EDWARDS (M.D.) does?
Insurance directories may phrase it differently, but here MIRANDA NICOLE EDWARDS (M.D.) maps to Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to MIRANDA NICOLE EDWARDS (M.D.)?
MIRANDA NICOLE EDWARDS (M.D.) shows a connection to Peoria, Illinois in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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