Individual provider Active NPI

Kirk A. Miller, MD

  • Anesthesiology Physician
  • Boise, ID
National Provider Identifier
1124075056
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M6844 Issued in ID
Practice address
600 Robbins Rd
Suite 401
Boise, ID 83702-4565
Phone
(208) 489-4279
Fax
(208) 424-8555
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X M6844 ID
General Practice Physician 208D00000X M6844 ID
Anesthesiology Physician 207L00000X M6844 ID Primary

Addresses

Primary practice location

600 Robbins Rd
Suite 401
Boise, ID 83702-4565

Mailing address

PO Box 9589
Boise, ID 83707-4589
Phone (208) 472-8123

Other identifiers 1

IdentifierTypeStateIssuer
003819100MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20100802000441 ID Practitioner - Anesthesiology 9931194776 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6844IDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Ambulatory Anesthesia PLLC Anesthesiology CurrentSince Jul 1, 2001 Accepting new patients

Locations

600 N Robbins Rd
Ste 401
Boise, ID 83702
Phone (208) 489-4279

875 S Vanguard Way
Ste 120
Meridian, ID 83642
Phone (208) 367-6416

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1124075056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9589",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837074589",
            "telephone_number": "208-472-8123",
            "fax_number": "208-344-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROBBINS RD",
            "address_2": "SUITE 401",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024565",
            "telephone_number": "208-489-4279",
            "fax_number": "208-424-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KIRK",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "ID",
            "license": "M6844",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ID",
            "license": "M6844",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ID",
            "license": "M6844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003819100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.