Individual provider Active NPI

Samantha Alexis Miller, PA-C

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1083186423
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9151 Issued in AZ
Practice address
5301 E Grant Rd BLDG 1
Tucson, AZ 85712-2805
Phone
(520) 784-6200
Fax
(520) 784-6109
NPI assigned
Dec 26, 2018
Last updated
Jul 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9151 AZ Primary
Medical Physician Assistant 363AM0700X 9151 AZ
Surgical Physician Assistant 363AS0400X 9151 AZ

Addresses

Primary practice location

5301 E Grant Rd BLDG 1
Tucson, AZ 85712-2805

Mailing address

PO Box 31630
Tucson, AZ 85751-1630
Phone (520) 784-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190222000142 NM Practitioner - Physician Assistant 8820337652 Reassigns benefits to 1 organization
I20220714003931 AZ Practitioner - Physician Assistant 8820337652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 784-6200

6320 N la Cholla Blvd
Suite 200
Tucson, AZ 85741-3549
Phone (520) 382-8200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Orthopaedic Institute Professional Corporation Physician Assistant CurrentSince Jul 1, 2022 Accepting new patients
Tucson Orthopaedic Institute Professional Corporation Physician Assistant CurrentSince Jul 1, 2022 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Surgery CurrentSince Jan 12, 2019 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Jan 12, 2019 Accepting new patients

Locations

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

5301 E Grant Rd
Bldg 1
Tucson, AZ 85712

6320 N La Cholla Blvd
Ste 200
Tucson, AZ 85741

1900 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-1820

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 726-6875

2111 College Dr
Gallup, NM 87301
Phone (505) 397-5172

Organizations & group practices 4

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": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1083186423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31630",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511630",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD BLDG 1",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SAMANTHA",
        "middle_name": "ALEXIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9151",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "9151",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "9151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.