NPIMap

Individual provider Active NPI

Russell Paul Miller, M.D.

  • Family Medicine Physician
  • Patton, PA
National Provider Identifier
1174522270
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD060029L Issued in PA
Practice address
121 Beech Ave
Patton, PA 16668-1017
Phone
(814) 674-5225
Fax
(814) 674-2338
NPI assigned
Jul 20, 2005
Last updated
Dec 29, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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 MD060029L PA Primary

Addresses

Primary practice location

121 Beech Ave
Patton, PA 16668-1017

Mailing address

121 Beech Ave
Patton, PA 16668-1017
Phone (814) 674-5225

Other identifiers 1

IdentifierTypeStateIssuer
0016115020008MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101025000908 PA Practitioner - Family Practice 0042260309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians
Vantage Physical Therapy and Rehabilitation IncGroup PAC ID 3072424886, 253 clinicians

Practice addresses (Care Compare)

121 Beech Ave
Patton, PA 16668-1017
Phone (814) 674-5225

205 Hampton Ave
Punxsutawney, PA 15767-2133
Phone (814) 938-0148

336 Bloomfield St
Johnstown, PA 15904-3271
Phone (814) 269-2224

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Miller MD Family Practice PC Family Medicine CurrentSince Dec 1, 2002 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

121 Beech Ave
Patton, PA 16668
Phone (814) 674-5225

Interoperability endpoints

  • Direct secure messaging: russell.miller@mfmedg.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1174522270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BEECH AVE",
            "city": "PATTON",
            "state": "PA",
            "postal_code": "166681017",
            "telephone_number": "814-674-5225",
            "fax_number": "814-674-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BEECH AVE",
            "city": "PATTON",
            "state": "PA",
            "postal_code": "166681017",
            "telephone_number": "814-674-5225",
            "fax_number": "814-674-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RUSSELL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD060029L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016115020008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Patton, PA

Sources for this page

Verify at the official NPI Registry.