Individual provider Active NPI

Colin Tolentino Millar, MD

  • Family Medicine Physician
  • Columbus, WI
National Provider Identifier
1134682016
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
75923-20 Issued in WI
Practice address
1515 Park Ave
Columbus, WI 53925-2402
Phone
(920) 623-2200
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 75923-20 WI Primary

Addresses

Primary practice location

1515 Park Ave
Columbus, WI 53925-2402

Mailing address

1515 Park Ave
Columbus, WI 53925-2402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20220927003282 WI Practitioner - Family Practice 9335525468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Ridge Health IncGroup PAC ID 6800791484, 70 clinicians

Practice addresses (Care Compare)

1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200

Hospital & facility affiliations

  • Columbus Community Hospital Hospital, Columbus, WI, CCN 521338

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75923-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Ridge Health Inc. Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Prairie Ridge Health, Inc. Current Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Jan 7, 2026 Accepting new patients
Prairie Ridge Health, Inc. PastSince Feb 6, 2022 Accepting new patients

Locations

134 Corporate Dr
Beaver Dam, WI 53916
Phone (920) 356-1000

1515 Park Ave
#1
Columbus, WI 53925

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

Interoperability endpoints

  • Direct secure messaging: cmillar626962@direct.emplifyhealth.org
  • Direct secure messaging: cmillar432738@direct-ehr-ssmhc.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/a87187e5-fe2f-447e-bf32-4eeb3954a735/

Organizations & group practices 6

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 3

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1134682016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539252402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539252402",
            "telephone_number": "920-623-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLAR",
        "first_name": "COLIN",
        "middle_name": "TOLENTINO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "75923-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, WI

Sources for this page

Verify at the official NPI Registry.