Active NPI
Jeff Miller, MD
- Pediatrics Physician
- Santa Rosa, CA
National Provider Identifier
1073607438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G33273
- Practice address
- 3925 Old Redwood Hwy
Santa Rosa, CA 95403-1719 - Phone
- (707) 566-5312
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G33273 | CA | Primary |
Addresses
Primary practice location
3925 Old Redwood Hwy
Santa Rosa, CA 95403-1719
Mailing address
3925 Old Redwood Hwy
Santa Rosa, CA 95403-1719
Phone (707) 566-5312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140814000717 | CA | Order and Referring Only - Pediatric Medicine | 2769609783 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G33273 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073607438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3925 OLD REDWOOD HWY",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954031719",
"telephone_number": "707-566-5312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3925 OLD REDWOOD HWY",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954031719",
"telephone_number": "707-566-5312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JEFF",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G33273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.