CONSTANTINO DIAZ MIRANDA (MD) – Emergency Medicine Physician, NPI 1093782963

CONSTANTINO DIAZ MIRANDA (MD) is a healthcare provider. based in Newport, Tennessee. specializing in Emergency Medicine Physician. They hold the professional credentials MD. They hold a License No. TN021298 (TN). The NPI Number for CONSTANTINO DIAZ MIRANDA (MD) is 1093782963

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
CONSTANTINO DIAZ MIRANDA (MD)
NPI
1093782963
Phone
(423) 625-2200
Address
435 2ND STREET
Enumeration Date
1 March 2006
Last Update Date
21 August 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8659837211
Graduation Year
1982 (44 years ago)
PAC ID
0244213759
Group Practice PAC ID
8123251766
Professional Enrollment ID
I20050103000838
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for CONSTANTINO DIAZ MIRANDA (MD)

  • Newport Medical Center, 435, 2nd Street, Eastport, Newport, Cocke County, East Tennessee, Tennessee, 37821, United States

    NEWPORT, TN 378213703

    Phone: (423) 625-2200

    Type: Location

  • PO BOX 30707

    KNOXVILLE, TN 379300707

    Phone:

    Type: Mailing

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: 2005-01-03

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
I20050103000838IEmergency MedicineTNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37821)

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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: 8123251766View full group profile

Reviews

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Frequently asked questions

What is CONSTANTINO DIAZ MIRANDA (MD)'s NPI number?
CONSTANTINO DIAZ MIRANDA (MD)'s NPI is 1093782963 — the number used across U.S. healthcare to identify this provider.
Is CONSTANTINO DIAZ MIRANDA (MD) still an active registrant?
CONSTANTINO DIAZ MIRANDA (MD) carries an active NPI according to the public dataset.
What kind of doctor is CONSTANTINO DIAZ MIRANDA (MD)?
CONSTANTINO DIAZ MIRANDA (MD) is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Tennessee is CONSTANTINO DIAZ MIRANDA (MD) registered?
Use Newport, Tennessee as the headline location for CONSTANTINO DIAZ MIRANDA (MD) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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