Individual provider Active NPI

Matthew C Miller, MD

  • Internal Medicine Physician
  • Radnor, PA
National Provider Identifier
1104865617
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD027542E Issued in PA
Practice address
250 King of Prussia Rd
Radnor, PA 19087-5235
Phone
(610) 902-5700
Fax
(610) 902-5704
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD027542E PA Primary

Addresses

Primary practice location

250 King of Prussia Rd
Radnor, PA 19087-5235

Mailing address

250 King of Prussia Rd
Radnor, PA 19087-5235
Phone (610) 902-5600

Other identifiers 1

IdentifierTypeStateIssuer
0014009560005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110601000250 PA Practitioner - Internal Medicine 5991982969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of the University of PennsylvaniaGroup PAC ID 2062326507, 150 clinicians

Practice addresses (Care Compare)

145 King of Prussia Rd
Radnor, PA 19087-4557
Phone (610) 902-5600

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Internal Medicine CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients

Locations

3400 Spruce St
Fl 6
Philadelphia, PA 19104
Phone (215) 615-0800

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

250 King of Prussia Rd
#6
Radnor, PA 19087
Phone (610) 902-2000

145 King of Prussia Rd
Ste 205
Wayne, PA 19087
Phone (610) 902-4858

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.

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1104865617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875235",
            "telephone_number": "610-902-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875235",
            "telephone_number": "610-902-5700",
            "fax_number": "610-902-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD027542E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014009560005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Radnor, PA

Sources for this page

Verify at the official NPI Registry.