Individual provider Active NPI

Michael Miller, M.D.

  • Emergency Medicine Physician
  • Georgetown, TX
National Provider Identifier
1093765935
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
L5054 Issued in TX
Practice address
360 Westbury LN
Georgetown, TX 78628-4374
Phone
(512) 508-3189
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Toxicology (Emergency Medicine) Physician 207PT0002X L5054 TX
Medical Toxicology (Emergency Medicine) Physician 207PT0002X G85817 CA
Emergency Medicine Physician 207P00000X L5054 TX Primary

Addresses

Primary practice location

360 Westbury LN
Georgetown, TX 78628-4374

Mailing address

360 Westbury LN
Georgetown, TX 78628-4374
Phone (512) 508-3189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040526000184 TX Practitioner - Emergency MedicinePractitioner - Medical OncologyPractitioner - Medical Toxicology 6608857768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Medical Oncology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Emergency Physicians, PLLCGroup PAC ID 6204280480, 108 clinicians

Practice addresses (Care Compare)

600 Elizabeth St
Corpus Christi, TX 78404-2235
Phone (361) 881-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G85817CAMDMedical Toxicology (Emergency Medicine) Physician
L5054TXMDMedical Toxicology (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Emergency Physicians, PLLC Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Conner Emergency Medicine Associates, PA Emergency Medicine CurrentSince Feb 15, 2018 Accepting new patients
Palestine Principal Healthcare Limited Partnership Emergency Medicine Past Accepting new patients
Islands Emergency Medical Service Hawaii, LLC Past Accepting new patients

Locations

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

2606 Hospital Blvd
Corpus Christi, TX 78405
Phone (361) 902-4151

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

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 and National Provider Directory roles.

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1093765935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WESTBURY LN",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786284374",
            "telephone_number": "512-508-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 WESTBURY LN",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786284374",
            "telephone_number": "512-508-3189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "TX",
            "license": "L5054",
            "primary": false
        },
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "CA",
            "license": "G85817",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L5054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.