Individual provider Active NPI

Alexandra Jean Miller, PA

  • Physician Assistant
  • Brighton, CO
National Provider Identifier
1073124590
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006314 Issued in CO
Practice address
1860 E Egbert St
Brighton, CO 80601-2404
Phone
(303) 697-2583
Fax
(303) 655-4924
NPI assigned
Aug 10, 2020
Last updated
Nov 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0006314 CO Primary

Addresses

Primary practice location

1860 E Egbert St
Brighton, CO 80601-2404

Mailing address

203 S Rollie Ave
Fort Lupton, CO 80621-1508
Phone (303) 892-6401

Other identifiers 1

IdentifierTypeStateIssuer
9000184561MedicaidCO

Other names 1

  • Alexandra Walkush Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200817001314 CO Practitioner - Physician Assistant 8628494036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Family HealthGroup PAC ID 3173433398, 75 clinicians

Practice addresses (Care Compare)

30 S 20TH Ave
Brighton, CO 80601-3705
Phone (303) 655-1950

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Family Health Current Accepting new patients
Salud Family Health CurrentSince Aug 17, 2020 Accepting new patients
Salud Family Health CurrentSince Aug 17, 2020 Accepting new patients
Salud Family Health Past Accepting new patients
Salud Family Health Past Accepting new patients

Locations

1860 E Egbert St
Brighton, CO 80601
Phone (303) 659-4000

203 S Rollie Ave
Fort Lupton, CO 80621
Phone (303) 286-4560

5995 Iris Pkwy
Frederick, CO 80504
Phone (303) 833-2050

Interoperability endpoints

  • Direct secure messaging: alexandra.miller@sfhc.eclinicaldirectplus.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 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": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1073124590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-892-6401",
            "fax_number": "303-286-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 E EGBERT ST",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012404",
            "telephone_number": "303-697-2583",
            "fax_number": "303-655-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALEXANDRA",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000184561",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "WALKUSH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brighton, CO

Sources for this page

Verify at the official NPI Registry.