Individual provider Active NPI

Mark Leland Miller, MD

  • Pediatric Orthopaedic Surgery Physician
  • Portland, OR
National Provider Identifier
1053576215
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
MD229197 Issued in OR
Practice address
3101 SW Sam Jackson Park Rd Ste 1B
Portland, OR 97239-3095
Phone
(503) 221-3424
Fax
(503) 221-3490
NPI assigned
Jul 26, 2008
Last updated
Apr 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD229197 OR
Pediatric Orthopaedic Surgery Physician 207XP3100X MD229197 OR Primary

Addresses

Primary practice location

3101 SW Sam Jackson Park Rd Ste 1B
Portland, OR 97239-3095

Mailing address

3101 SW Sam Jackson Park Rd
Portland, OR 97239-3095
Phone (503) 221-3424

Other practice location 1

9135 SW Barnes Rd Ste 763
Portland, OR 97225-6777
Phone (503) 216-6560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140428001280 MO Practitioner - Orthopedic Surgery 0547493546 Reassigns benefits to 2 organizations
I20260406001439 OR Practitioner - Orthopedic Surgery 0547493546 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Harvard Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1400 SW 5TH Ave FL
Suite 5
Portland, OR 97201-5509

PO
Pasadena, CA 91110

PO
Suite 4180
Pasadena, CA 91110-4180

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD229197ORMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children Pediatric Orthopaedic Surgery Current Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 2, 2014 Accepting new patients
Washington University CurrentSince Jun 1, 2014 Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 2, 2014 Accepting new patients
Washington University CurrentSince Jun 1, 2014 Accepting new patients
Washington University Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

1 Childrens Pl
#4S60
Saint Louis, MO 63110

1 Childrens Pl
Ste 1B
Saint Louis, MO 63110
Phone (314) 454-6062

4400 Clayton Ave
Saint Louis, MO 63110
Phone (314) 432-3600

4921 Parkview Pl
Ste 6A6B12A
Saint Louis, MO 63110
Phone (314) 747-2551

660 S Euclid Ave
#8233
Saint Louis, MO 63110
Phone (314) 747-2494

660 S Euclid Ave
#C
Saint Louis, MO 63110

3101 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 221-3424

3101 SW Sam Jackson Park Rd
Ste 1B
Portland, OR 97239
Phone (503) 221-3424

Networks

  • IA HMO C-SNP
  • IA HMO

Interoperability endpoints

  • Direct secure messaging: mmiller155631@direct.carenet.org

Organizations & group practices 10

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 1

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": "1217030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1053576215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393095",
            "telephone_number": "503-221-3424",
            "fax_number": "503-221-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SW SAM JACKSON PARK RD STE 1B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393095",
            "telephone_number": "503-221-3424",
            "fax_number": "503-221-3490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9135 SW Barnes Rd Ste 763",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256777",
            "country_code": "US",
            "telephone_number": "503-216-6560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARK",
        "middle_name": "LELAND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-26",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD229197",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "OR",
            "license": "MD229197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.