Individual provider Active NPI

Daniel Raymond Miller, MD

  • Specialist
  • Lewiston, ID
National Provider Identifier
1154468775
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
M-3254 Issued in ID
Practice address
321 Skyline Dr
Lewiston, ID 83501-4220
Phone
(208) 791-6718
Fax
(208) 743-0528
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X M-3254 ID Primary

Addresses

Primary practice location

321 Skyline Dr
Lewiston, ID 83501-4220

Mailing address

321 Skyline Dr
Lewiston, ID 83501-4220
Phone (208) 791-6718

Other identifiers 1

IdentifierTypeStateIssuer
,OO2456100MedicaidIA

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
I20100810000868 ID Practitioner - Otolaryngology 9830223080 Practice locations: Lewiston, ID

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, San Francisco School of Medicine, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

321 Skyline Dr
Lewiston, ID 83501-4220
Phone (208) 791-6718

Hospital & facility affiliations

  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion35
Laminectomy or laminotomy (partial removal of spine bones)16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-3254IDMDSpecialist

Hospital & facility affiliations 2

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154468775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 SKYLINE DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014220",
            "telephone_number": "208-791-6718",
            "fax_number": "208-743-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 SKYLINE DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014220",
            "telephone_number": "208-791-6718",
            "fax_number": "208-743-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DANIEL",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "M-3254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": ",OO2456100",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.