Individual provider Active NPI

Jayson Miller

  • Certified Registered Nurse Anesthetist
  • Williamsport, PA
National Provider Identifier
1003229410
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN589568 Issued in PA
Practice address
338 Eldred St
Williamsport, PA 17701-2305
Phone
(570) 971-5153
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN589568 PA Primary

Addresses

Primary practice location

338 Eldred St
Williamsport, PA 17701-2305

Mailing address

338 Eldred St
Williamsport, PA 17701-2305

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140828001485 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921226234 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

700 High St
Williamsport, PA 17701-3100
Phone (570) 321-1279

Hospital & facility affiliations

  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN589568PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulfstream Anesthesia Consultants PA Nurse Anesthetist, Certified Registered CurrentSince Aug 28, 2023 Accepting new patients
Anthracite Anesthesia Consultants, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 5, 2024 Accepting new patients
Rgal Anesthesia Services LLC CurrentSince Dec 23, 2023 Accepting new patients
Susquehanna Physician Services CurrentSince Jul 1, 2020 Accepting new patients
Susquehanna Physician Services Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2020 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

701 E 16th St
Berwick, PA 18603
Phone (570) 754-5000

61 Industrial Dr
Hamburg, PA 19526
Phone (570) 617-7024

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

2104 Harrisburg Pike
Ste 300
Lancaster, PA 17601
Phone (717) 544-3400

215 E Water St
Muncy, PA 17756
Phone (570) 327-8137

275 Guthrie Dr
Troy, PA 16947
Phone (570) 297-2121

1327 Highway 315 Blvd
Ste 1
Wilkes Barre, PA 18702
Phone (570) 616-8589

1100 Grampian Blvd
#P
Williamsport, PA 17701
Phone (570) 326-8457

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

1201 Grampian Blvd
Ste 1K
Williamsport, PA 17701

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1003229410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 ELDRED ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177012305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 ELDRED ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177012305",
            "telephone_number": "570-971-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JAYSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN589568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.