Kenneth R Miller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C5-0011539 Issued in DE

Practice address

640 S State St
Dover, DE 19901-3530

Phone

(302) 744-6166

Fax

(302) 735-3845

NPI assigned

Aug 23, 2016

Last updated

Oct 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bayhealth Medical Center, IncGroup PAC ID 1658364740, 399 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Bayhealth Medical Center, Inc.

  dba Bayhealth Observation Physicians

  • Emergency Medicine Physician
  • Dover, DE
  • NPI 1679072144
  Medicare reassignment Care Compare group NPD
• Bayhealth Emergency Physicians LLC

  • Emergency Medicine Physician
  • Dover, DE
  • NPI 1073012696
  Medicare reassignment
• Bayhealth Medical Center, Inc.

  dba Bayhealth Hospital, Sussex Campus

  • General Acute Care Hospital
  • Milford, DE
  • NPI 1023006434
  Medicare reassignment
• Bayhealth Medical Center, Inc

  • Gastroenterology Physician
  • Milford, DE
  • NPI 1639938525
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bayhealth Medical Center, Inc.

  dba Bayhealth Hospital, Kent Campus

  • General Acute Care Hospital
  • Dover, DE
  • NPI 1467546135
  Care Compare affiliation

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1154876712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-744-6166",
            "fax_number": "302-735-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-23",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Miller
• Christie L Miller, MD
• Elizabeth Miller, BSN, RN, DE
• Erin Catherine Miller, LCSW
• Jill Miller
• Laurel Frances Miller, MSN, CNM, WHNP
• Meghan Elizabeth Miller, CNM, WHNP
• Michael F. Miller, LPCMH
• Raymond E Miller, M.D.
• Stacy Miller

• Physician Assistant in Dover, DE
• Providers in Dover, DE by specialty
• Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.