Active NPI
Jack Steve Miller, M.D.
- Urology Physician
- Tulsa, OK
National Provider Identifier
1093737538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 11890
- Practice address
- 10901 E 48TH St
Tulsa, OK 74146-5830 - Phone
- (918) 749-8765
- Fax
- (918) 392-2155
- NPI assigned
- Jul 24, 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 11890 | OK | Primary |
Addresses
Primary practice location
10901 E 48TH St
Tulsa, OK 74146-5830
Mailing address
10901 E 48TH St
Tulsa, OK 74146-5830
Phone (918) 749-8765
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100135260A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110408000556 | OK | Practitioner - Urology | 2163503988 | Reassigns benefits to 1 organization |
| I20140821002112 | AR | Practitioner - Urology | 2163503988 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Oklahoma College of Medicine, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Urologic Specialists of Oklahoma Inc
Practice addresses (Care Compare)
10901 E 48TH St
Tulsa, OK 74146-5830
Phone (918) 749-8765
6801 Rogers Ave
Suite 202
Fort Smith, AR 72903-4067
Phone (918) 749-8765
Hospital & facility affiliations
- Ascension St John Medical Center
- St John Owasso
- Oklahoma Surgical Hospital, LLC
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11890 | OK | MD | Urology Physician |
Interoperability endpoints
- jackmiller@usoinc.medalliesdirect.net
- jack.miller@direct.stjohnhealthsystem.com
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Oklahoma Surgical Hospital LLC | Hospital | General Partnership Interest (0.52%) | Jan 15, 2008 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1487651857
General Partnership Interest
Organizations & group practices 3
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.
-
- Urology Physician
- Owasso, OK
- NPI 1619789310
-
- Urology Physician
- Fort Smith, AR
- NPI 1831944487
Hospital & facility affiliations 4
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": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656979200000",
"number": "1093737538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10901 E 48TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741465830",
"telephone_number": "918-749-8765",
"fax_number": "918-392-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10901 E 48TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741465830",
"telephone_number": "918-749-8765",
"fax_number": "918-392-2155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JACK",
"middle_name": "STEVE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2022-07-05",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OK",
"license": "11890",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100135260A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.