Glenn Miller, M.D.
Individual provider Active NPI Pain Medicine (Anesthesiology) Physician · Philadelphia, PA
NPI 1174697346 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1174697346
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pain Medicine (Anesthesiology) Physician 207LP2900X
- License
- MD033553E (PA)
- Practice address
- 2410 S Broad St
3Rd FLR
Philadelphia, PA 19145-4418 - Phone
- (215) 462-6600
- Fax
- (215) 462-2650
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Pain Management
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2410 S Broad St
Philadelphia, PA 19145-4418
Phone (215) 462-6600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041013000349 | PA | Practitioner - Pain Management |
5496739799 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD033553E | PA | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spinal Care Pain Associates, P.C. | Current |
Accepting new patients | |
| Spinal Care Pain Associates P C | Current | Accepting new patients | |
| Pain Care Institute | Past | Accepting new patients | |
| Clinical Pain Management Associates, PC | Past | Accepting new patients | |
| Delaware Valley Anesthesia Associates, PC | Past | Accepting new patients | |
| A J Woodring MD Associates | Past | Accepting new patients |
Locations
2410 S Broad St
Fl 3
Philadelphia, PA 19145
Phone (215) 462-6600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | MD033553E | PA | Yes |
Addresses
Primary practice location
2410 S Broad St
3Rd FLR
Philadelphia, PA 19145-4418
Mailing address
3831 Ramage Run
Huntingdon Valley, PA 19006-2453
Phone (215) 938-0254
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20033920 | Other | NJ | AMERIHEALTH MERCY |
| 050088759 | Other | PA | RR MEDICARE |
| 30003770 | Other | NJ | HORIZON NJ HEALTH |
| 011223020 | Medicaid | PA | |
| 517607 | Other | NJ | AMERIHEALTH ADMINISTRATOR |
| 0112230205 | Other | PA | ALL IBC PRODUCTS |
| 3039 | Other | PA | BRAVO BY ELDER HEALTH |
| 517607 | Other | PA | ALL BLUE SHIELD |
| 0111120000 | Other | NJ | AMERIHEALTH PC & HMO |
| 2992866 | Other | PA | AETNA |
| 30003770 | Other | PA | KEYSTONE MERCY |
Other providers in Philadelphia, PA
- Erin Leigh Miller
- Evan Richard Miller
- Eydie G Miller
- Fran Miller
- Francis L Miller
- Hayley A Miller
- Ilana Miller
- J Evan Miller
- Jacob Miller
- Jamie L Miller
All providers in Philadelphia, PA · Pain Medicine (Anesthesiology) Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.