Individual provider Active NPI

Andrew Tyler Miller, MD

  • Diagnostic Radiology Physician
  • Waconia, MN
National Provider Identifier
1083022198
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
66523 Issued in MN
Practice address
500 S Maple St
Waconia, MN 55387-1791
Phone
(952) 442-2191
NPI assigned
Aug 1, 2014
Last updated
May 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 66523 MN Primary

Addresses

Primary practice location

500 S Maple St
Waconia, MN 55387-1791

Mailing address

500 S Maple St
Waconia, MN 55387-1791
Phone (952) 442-2191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 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
I20200522000104 MN Practitioner - Diagnostic Radiology 3870824527 Reassigns benefits to 12 organizations
I20201023002738 ND Practitioner - Diagnostic Radiology 3870824527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Wisconsin School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

111 Hundertmark Rd
Chaska, MN 55318-4551
Phone (952) 856-4001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Community Hospital, Inc. CurrentSince Aug 31, 2023 Accepting new patients
Minnesota Valley Health Center Inc CurrentSince Dec 31, 2023 Accepting new patients
Allina Health System Current Accepting new patients
St Francis Regional Medical Center CurrentSince Jul 1, 2020 Accepting new patients
Stevens Community Medical Center Inc CurrentSince Jul 6, 2022 Accepting new patients
Stevens Community Medical Center Inc. Current Accepting new patients
St. Francis Regional Medical Center CurrentSince Jul 1, 2020 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Glencoe Regional Health Services CurrentSince Jul 1, 2020 Accepting new patients
Glencoe Regional Health Services CurrentSince Jul 1, 2020 Accepting new patients
Ridgeview Medical Center Current Accepting new patients
Mankato Clinic LTD Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Mercy Medical Center Diagnostic Radiology CurrentSince Sep 21, 2020 Accepting new patients
Stevens Community Medical Center Inc CurrentSince Jul 6, 2022 Accepting new patients
Noran Neurological Clinic P.a. CurrentSince Jul 1, 2020 Accepting new patients
Minnesota Valley Health Center Inc Current Accepting new patients
Sibley Medical Center CurrentSince Dec 31, 2023 Accepting new patients
Mercy Medical Center Current Accepting new patients
Ridgeview Medical Center Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Mercy Home Care CurrentSince Sep 21, 2020 Accepting new patients
Allina Health System CurrentSince Jul 1, 2020 Accepting new patients
Warren Community Hospital, Inc. CurrentSince Aug 31, 2023 Accepting new patients
Allina Health System CurrentSince Jul 1, 2020 Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology PastSince Jul 1, 2020 Accepting new patients
Quest Diagnostics LLC Il PastSince Jul 1, 2020 Accepting new patients

Locations

3369 Solutions Ctr
Chicago, IL 60677

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Chaska, MN 55318
Phone (952) 361-2447

111 Hundertmark Rd
Ste 130
Chaska, MN 55318
Phone (952) 456-7400

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375

121 Drew Ave SE
Madelia, MN 56062
Phone (507) 642-3255

1230 E Main St
Mankato, MN 56001
Phone (507) 389-8502

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2828 Chicago Ave
Ste 200
Minneapolis, MN 55407
Phone 61287910001502

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

3601 Minnesota Dr
Ste 200
Minneapolis, MN 55435
Phone (952) 992-5691

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

400 E 1st St
Morris, MN 56267
Phone (320) 589-1313

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

300 W Good Samaritan Dr
Warren, MN 56762
Phone (218) 745-4211

1301 15th Ave W
Williston, ND 58801
Phone (701) 774-7400

Organizations & group practices 25

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.

View all 25

Hospital & facility affiliations 3

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": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1083022198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871791",
            "telephone_number": "952-442-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871791",
            "telephone_number": "952-442-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANDREW",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-01",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "66523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.