Benjamin J Miller, ARNP
Individual provider Active NPI Nurse Practitioner · Missoula, MT
NPI 1255356291 · NPPES record last updated Oct 27, 2015
Key facts
- NPI
- 1255356291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN26399 (MT)
- Practice address
- 2120 S Reserve St # 133
Missoula, MT 59801-6451 - Phone
- (406) 550-9012
- Fax
- (801) 772-7767
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wolf Point Clinic Association Inc
Alaska Native Tribal Health Consortium
Practice addresses (Care Compare)
301 Knapp St
Wolf Point, MT 59201-1826
Phone (406) 653-6437
4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662
Hospital & facility affiliations
- Trinity Hospital
- Poplar Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MT, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070124000131 | MT | Practitioner - Nurse Practitioner | 7517968225 | Reassigns benefits to 2 organizations |
| I20260624005104 | TX | Practitioner - Nurse Practitioner | 7517968225 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN26399 | MT | MD | Nurse Practitioner |
| AP30006070 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Family Clinic | Current |
Accepting new patients | |
| Northeast Montana Health Services Inc | Past | Accepting new patients | |
| Northeast Montana Health Services, Inc. | Past | Accepting new patients | |
| Holy Rosary Healthcare | Past | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021
400 S Clark St
Butte, MT 59701
Phone (406) 495-7260
315 Knapp St
Wolf Point, MT 59201
Phone (406) 653-6500
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/ac22fd4c-796d-4bb8-9292-da1e40231549/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP30006070 | WA | |
| Nurse Practitioner | 363L00000X | RN26399 | MT | Yes |
Addresses
Primary practice location
2120 S Reserve St # 133
Missoula, MT 59801-6451
Mailing address
17207 146TH Seave
Renton, WA 98058-8700
Phone (406) 550-9256
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9632027 | Medicaid | WA |
Other providers in Missoula, MT
- Wendy E. Miklos
- Lisa J Milch
- Paisley L. Miles
- McKenna Leigh Mill
- Benjamin Eric Miller Castellanos
- Chelsey Miller
- Cindy L Miller
- Emily Miller
- Hannah Miller
- Hayley Ann Miller
All providers in Missoula, MT · Nurse Practitioner in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2015. 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.