Individual provider Active NPI

Aubrey M Miller, MD

  • Family Medicine Physician
  • Clackamas, OR
National Provider Identifier
1083103287
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD204414 Issued in OR
Practice address
9775 SE Sunnyside Rd
Clackamas, OR 97015-5739
Phone
(503) 655-8471
NPI assigned
May 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PG188834 OR
Family Medicine Physician 207Q00000X MD204414 OR Primary

Addresses

Primary practice location

9775 SE Sunnyside Rd
Clackamas, OR 97015-5739

Mailing address

9775 SE Sunnyside Rd Ste 200
Clackamas, OR 97015-5721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221129000842 OR Practitioner - Family Practice 1254687957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Clackamas Office of County AuditorGroup PAC ID 9537065560, 75 clinicians

Practice addresses (Care Compare)

39740 Pleasant St
Sandy, OR 97055-6412
Phone (503) 655-8471

9775 SE Sunnyside Rd
Suite 200
Clackamas, OR 97015-5721
Phone (503) 655-8471

Hospital & facility affiliations

  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
  • Adventist Health Portland Hospital, Portland, OR, CCN 380060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD204414ORMDFamily Medicine Physician
PG188834ORMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Clackamas County Current Accepting new patients
County of Clackamas Office of County Auditor CurrentSince Aug 16, 2022 Accepting new patients

Locations

9775 SE Sunnyside Rd
Ste 200
Clackamas, OR 97015
Phone (503) 794-3830

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

39740 Pleasant St
Sandy, OR 97055
Phone (503) 563-7679

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1083103287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9775 SE SUNNYSIDE RD STE 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9775 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155739",
            "telephone_number": "503-655-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "AUBREY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "PG188834",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD204414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.