NPIMap

Individual provider Active NPI

Brian A Miller, MD

  • Family Medicine Physician
  • Goshen, IN
National Provider Identifier
1194977116
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01086687A Issued in IN
Practice address
1814 Charlton CT Ste a
Goshen, IN 46526-6463
Phone
(574) 533-4169
Fax
(574) 534-8822
NPI assigned
Oct 22, 2008
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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 01086687A IN Primary

Addresses

Primary practice location

1814 Charlton CT Ste a
Goshen, IN 46526-6463

Mailing address

1814 Charlton CT Ste a
Goshen, IN 46526-6463
Phone (574) 533-4169

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.miller@goshenhealthdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100929000153 TX Practitioner - Family Practice 4385760297 Reassigns benefits to 4 organizations
I20211102000586 IN Practitioner - Family Practice 4385760297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pittsburgh School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

1814 Charlton CT
A
Goshen, IN 46526-6463
Phone (574) 533-4169

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Health System Inc Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Goshen Health System, Inc Family Medicine CurrentSince Jun 9, 2024 Accepting new patients
Ton San Xavier Health Center CurrentSince Mar 1, 2016 Accepting new patients
Ton Sells Hospital CurrentSince Oct 21, 2017 Accepting new patients
Goshen Health System Inc CurrentSince Jan 1, 2022 Accepting new patients
Ton San Simon Health Center CurrentSince Mar 1, 2016 Accepting new patients
Goshen Hospital Association Inc Current Accepting new patients
Ton Santa Rosa Health Center CurrentSince Mar 1, 2016 Accepting new patients
Ton Santa Rosa Health Center Past Accepting new patients
Ton San Xavier Health Center Past Accepting new patients
Ton Sells Hospital Past Accepting new patients

Locations

7900 S J Stock Rd
Tucson, AZ 85746
Phone (520) 295-2550

1814 Charlton Ct
#A
Goshen, IN 46526
Phone (574) 533-4169

1814 Charlton Ct
Ste A
Goshen, IN 46526
Phone (574) 533-4169

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 534-6752

Interoperability endpoints

  • Direct secure messaging: brian.miller@goshenhealthdirect.com

Organizations & group practices 11

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 3

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": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1194977116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 CHARLTON CT STE A",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266463",
            "telephone_number": "574-533-4169",
            "fax_number": "574-534-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 CHARLTON CT STE A",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266463",
            "telephone_number": "574-533-4169",
            "fax_number": "574-534-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01086687A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.miller@goshenhealthdirect.com",
            "affiliation": "N",
            "endpointDescription": "Effective 5/15/23",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1814 Charlton Ct Ste A",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465266463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.