NPIMap

Individual provider Active NPI

Brandon Wayne Miller, D.O.

  • Family Medicine Physician
  • Fallbrook, CA
National Provider Identifier
1033179254
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A11653 Issued in CA
Practice address
521 E Elder St Ste 105
Fallbrook, CA 92028-3082
Phone
(760) 728-8344
Fax
(760) 728-6198
NPI assigned
Mar 23, 2006
Last updated
Feb 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 434 NE
Family Medicine Physician 207Q00000X 20A11653 CA Primary

Addresses

Primary practice location

521 E Elder St Ste 105
Fallbrook, CA 92028-3082

Mailing address

28780 Single Oak Dr
Suite 160
Temecula, CA 92590-3625
Phone (951) 676-4193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111027000724 CA Practitioner - Family Practice 0345413811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rancho Family Medical Group IncGroup PAC ID 6305741240, 112 clinicians

Practice addresses (Care Compare)

263 Church Ave
Chula Vista, CA 91910-2728
Phone (619) 422-1324

28780 Single Oak Dr
Temecula, CA 92590-5528
Phone (951) 676-4193

521 E Elder St
Suite 105
Fallbrook, CA 92028-3082
Phone 95167641932109

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions21
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A11653CAMDFamily Medicine Physician
434NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rancho Family Medical Group, Inc. Family Medicine CurrentSince Oct 1, 2011 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
Regents of the University of California Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients

Locations

263 Church Ave
Chula Vista, CA 91910
Phone (619) 422-1324

521 E Elder St
Ste 105
Fallbrook, CA 92028
Phone (760) 728-0703

3853 W Stetson Ave
Hemet, CA 92545
Phone (951) 929-6900

3853 W Stetson Ave
Ste 200
Hemet, CA 92545
Phone (951) 225-6802

28780 Single Oak Dr
Ste 160
Temecula, CA 92590
Phone (951) 658-9461

31720 US Highway 79
Ste 100
Temecula, CA 92592
Phone (909) 303-6300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: brandon.miller.1@11129.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1033179254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28780 SINGLE OAK DR",
            "address_2": "SUITE 160",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925903625",
            "telephone_number": "951-676-4193",
            "fax_number": "951-719-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E ELDER ST STE 105",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283082",
            "telephone_number": "760-728-8344",
            "fax_number": "760-728-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRANDON",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "434",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallbrook, CA

Sources for this page

Verify at the official NPI Registry.