Individual provider Active NPI

Jesse Julian Miller, M.D.

  • Sports Medicine (Family Medicine) Physician
  • State College, PA
National Provider Identifier
1114373131
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
MD479129 Issued in PA
Practice address
143 Hospital Drive
Ste 112
State College, PA 16803-6706
Phone
(800) 243-1455
Fax
(814) 863-7803
NPI assigned
May 9, 2016
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 84645 SC
Sports Medicine (Family Medicine) Physician 207QS0010X MD479129 PA Primary

Addresses

Primary practice location

143 Hospital Drive
Ste 112
State College, PA 16803-6706

Mailing address

500 University Dr
MC Ca410
Hershey, PA 17033-2360
Phone (800) 243-1455

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
I20220907003446 PA Practitioner - Family PracticePractitioner - Sports Medicine 2769713189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

143 Hospital Dr
Suite 112
State College, PA 16803-6705
Phone (814) 865-3566

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Sep 21, 2022 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Family Medicine CurrentSince Sep 21, 2022 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Family Medicine Past Accepting new patients

Locations

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#410
Hershey, PA 17033
Phone (717) 531-1159

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

3100 Schoolhouse Rd
Middletown, PA 17057
Phone (717) 948-5180

143 Hospital Dr
Ste 112
State College, PA 16803
Phone (814) 865-3566

1850 E Park Ave
Ste 112
State College, PA 16803
Phone (814) 235-4746

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 5

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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1114373131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "address_2": "MC CA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "800-243-1455",
            "fax_number": "717-531-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 HOSPITAL DRIVE",
            "address_2": "STE 112",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "800-243-1455",
            "fax_number": "814-863-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JESSE",
        "middle_name": "JULIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "84645",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD479129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.