Gregory Lee Miller, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

05909T Issued in CA

Practice address

138 N Grant Ave
Manteca, CA 95336-4601

Phone

(209) 823-7146

Fax

(209) 823-0670

NPI assigned

Feb 2, 2006

Last updated

Nov 12, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1043282262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 N GRANT AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364601",
            "telephone_number": "209-823-7146",
            "fax_number": "209-823-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 N GRANT AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364601",
            "telephone_number": "209-823-7146",
            "fax_number": "209-823-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GREGORY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "05909T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0059090",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD",
            "identifier": "45547",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "SD0059090",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MESC",
            "identifier": "3417",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bianca Mesinas
• Elizabeth Meza
• Michael M. Catz, M.D., Inc
• Michael R Matson DDS, Inc
• Amanda Miller, LAC.
• Howard Charles Miller, DPM
• Max William Miller, MD
• Matthew Hoyt Milnes, D.D.S.
• Marilou Ancheta Miranda
• Mirandahealth Medical Center Inc a Professional Nursing Corporation

• Optometrist in Manteca, CA
• Providers in Manteca, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.