NPIMap

Individual provider Active NPI

Kelly L Miller, M.D.

  • Interventional Cardiology Physician
  • Glen Burnie, MD
National Provider Identifier
1205897287
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
D61418 Issued in MD
Practice address
1417 Madison Park Drive
Glen Burnie, MD 21061
Phone
(410) 768-6600
Fax
(410) 553-0710
NPI assigned
Mar 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X D61418 MD
Interventional Cardiology Physician 207RI0011X D61418 MD Primary

Addresses

Primary practice location

1417 Madison Park Drive
Glen Burnie, MD 21061

Mailing address

1417 Madison Park Drive
Glen Burnie, MD 21061
Phone (410) 768-6600

Other identifiers 2

IdentifierTypeStateIssuer
004362100MedicaidMD
P00434480OtherMDMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20050913000936 MD Practitioner - Internal MedicinePractitioner - Interventional Cardiology 9032142880 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Interventional Cardiology
Education
University of Maryland School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7845 Oakwood Rd
Suite 106
Glen Burnie, MD 21061-4256
Phone (410) 768-0919

7845 Oakwood Rd
Suite 204
Glen Burnie, MD 21061-4257
Phone (410) 553-2900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting39
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians P.a. Cardiovascular Disease CurrentSince Nov 30, 2011 Accepting new patients
Baltimore Washington Medical Center Inc. Current Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 21, 2018 Accepting new patients
The Heart Center of Northern Anne Arundel County PA Cardiovascular Disease CurrentSince Aug 6, 2007 Accepting new patients
Baltimore Washington Medical Center Inc. CurrentSince Aug 15, 2014 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 21, 2018 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Nov 30, 2011 Accepting new patients
Baltimore Washington Medical Center Inc. CurrentSince Aug 15, 2014 Accepting new patients
University of Maryland Baltimore Washington Heart Associates LLC Cardiovascular Disease CurrentSince Jul 30, 2022 Accepting new patients
Union Memorial Hospital Past Accepting new patients
Home Dialysis of Maryland LLC Past Accepting new patients

Locations

419 W Redwood St
Ste 660
Baltimore, MD 21201
Phone (410) 328-3244

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

7845 Oakwood Rd
Ste 204
Glen Burnie, MD 21061
Phone (301) 553-0106

1417 Madison Park Dr
Glen Burnie, MD 21061
Phone (410) 768-6600

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

7845 Oakwood Rd
Ste 106
Glen Burnie, MD 21061
Phone (410) 760-5100

300 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4940

920 Elkridge Landing Rd
Fl 4
Linthicum Heights, MD 21090
Phone (443) 462-5010

Interoperability endpoints

  • Direct secure messaging: kmiller22906@direct.umm.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1205897287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 MADISON PARK DRIVE",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-768-6600",
            "fax_number": "410-553-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 MADISON PARK DRIVE",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-768-6600",
            "fax_number": "410-553-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D61418",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MD",
            "license": "D61418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004362100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00434480",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.