NPIMap

Individual provider Active NPI

Glenn Alan Miller, D.P.M.

  • Podiatrist
  • San Diego, CA
National Provider Identifier
1164457966
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3584 Issued in CA
Practice address
1809 National Ave
San Diego, CA 92113-2113
Phone
(619) 515-2300
NPI assigned
Jul 11, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3584 CA Primary

Addresses

Primary practice location

1809 National Ave
San Diego, CA 92113-2113

Mailing address

1809 National Ave
San Diego, CA 92113-2113
Phone (619) 515-2300

Other practice location 1

3544 30th St
San Diego, CA 92104-4120
Phone (619) 515-2424

Other practice location 2

8788 Jamacha Rd
Spring Valley, CA 91977-4035
Phone (619) 515-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070618000486 CA Practitioner - Podiatry 1153420062 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glenn a Miller DPM PCGroup PAC ID 3375912637, 3 clinicians

Practice addresses (Care Compare)

11076 Weatherwood Ter
San Diego, CA 92131-2669
Phone (424) 201-1526

11076 Weatherwood Terrace
San Diego, CA 92131-2669
Phone (424) 201-1526

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue14
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 9, 2013 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 9, 2013 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Glenn a. Miller, D.P.M.,P.C. Podiatrist CurrentSince Oct 31, 2022 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego Inc Current Accepting new patients
Convalescent Podiatry Care Podiatrist Past Accepting new patients
James F Eggold Podiatrist Past Accepting new patients

Locations

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

3544 30th St
San Diego, CA 92104
Phone (619) 515-2424

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

8788 Jamacha Rd
Spring Valley, CA 91977
Phone (619) 515-2380

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164457966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921132113",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921132113",
            "telephone_number": "619-515-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3544 30th St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921044120",
            "country_code": "US",
            "telephone_number": "619-515-2424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8788 Jamacha Rd",
            "address_purpose": "LOCATION",
            "city": "Spring Valley",
            "state": "CA",
            "postal_code": "919774035",
            "country_code": "US",
            "telephone_number": "619-515-2555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GLENN",
        "middle_name": "ALAN",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.