Active NPI
Justin Michael Miller, PA
- Surgical Physician Assistant
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 5601006970
- Practice address
- 1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406 - Phone
- (616) 459-7101
- NPI assigned
- Feb 5, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-01677 | NC | |
| Surgical Physician Assistant | 363AS0400X | 5601006970 | MI | Primary |
Addresses
Primary practice location
1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Mailing address
1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone (616) 459-7101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Center for Physical Rehabilitation Inc
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1774
1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone (616) 459-7101
1840 Wealthy St SE
Grand Rapids, MI 49506-2921
Phone (616) 774-7444
5060 Cascade Rd
Grand Rapids, MI 49546-3808
5060 Cascade Rd SE
Grand Rapids, MI 49546-3808
Hospital & facility affiliations
- Spectrum Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.51 of 100
- Quality
- 49.04
- Promoting interoperability
- 96
- Improvement activities
- 40
- Cost
- 82.67
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Associates of Grand Rapids PC | Current | Accepting new patients | |
| Southeast Pain Management Services, PLLC | Past | Accepting new patients | |
| American Anesthesiology of North Carolina, PLLC | Physician Assistant | Past | Accepting new patients |
| Orthopaedic Associates of Grand Rapids, PC | Physician Assistant | Past | Accepting new patients |
Locations
1111 Leffingwell Ave NE
Grand Rapids, MI 49525
Phone 61645971011381
1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525
Phone 61645971011381
2680 Leonard St NE
Grand Rapids, MI 49525
Phone (616) 224-1110
Interoperability endpoints
- justin.miller.p1@direct.oam.nextgenshare.com
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Grand Rapids, MI
- NPI 1023021300
Physician Assistant
-
- Physical Therapy Clinic/Center
- Grand Rapids, MI
- NPI 1902288863
-
- Durable Medical Equipment & Medical Supplies
- Grand Rapids, MI
- NPI 1740532035
-
- Pain Medicine (Anesthesiology) Physician
- Monroe, NC
- NPI 1174817993
Physician Assistant
-
- Pain Medicine (Anesthesiology) Physician
- Charlotte, NC
- NPI 1255396933
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400198400000",
"number": "1003055666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 LEFFINGWELL AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495256406",
"telephone_number": "616-459-7101",
"fax_number": "616-954-6483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 LEFFINGWELL AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495256406",
"telephone_number": "616-459-7101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JUSTIN",
"middle_name": "MICHAEL",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-05",
"last_updated": "2014-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-01677",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MI",
"license": "5601006970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.