Active NPI
Matthew Allan Miller
- Plastic Surgery Physician
- Kansas City, KS
National Provider Identifier
1235691841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 1
- Practice address
- 3901 Rainbow Blvd
Kansas City, KS 66160-8500 - Phone
- (913) 588-5000
- NPI assigned
- Apr 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 1 | KS | Primary |
Addresses
Primary practice location
3901 Rainbow Blvd
Kansas City, KS 66160-8500
Mailing address
6401 W 52ND St
Mission, KS 66202-1684
Phone (785) 424-4463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190717003513 | KS | Order and Referring Only - Plastic and Reconstructive Surgery | 6800121591 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- mmiller315955@northwell.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554163200000",
"number": "1235691841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6401 W 52ND ST",
"city": "MISSION",
"state": "KS",
"postal_code": "662021684",
"telephone_number": "785-424-4463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 RAINBOW BLVD",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661608500",
"telephone_number": "913-588-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MATTHEW",
"middle_name": "ALLAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-02",
"last_updated": "2019-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "KS",
"license": "1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.