Michael Miller, D.O.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

05008632L Issued in PA

Practice address

676 Wyoming Ave
Suite 104
Kingston, PA 18704-3857

Phone

(570) 287-1400

NPI assigned

Apr 7, 2006

Last updated

Apr 30, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Debra T Miller MD LLC

  • Family Medicine Physician
  • Plains, PA
  • NPI 1710176466
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1255394714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 PIERCE ST",
            "address_2": "STE 205",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045512",
            "telephone_number": "570-287-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 WYOMING AVE",
            "address_2": "SUITE 104",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043857",
            "telephone_number": "570-287-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS008632L",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "05008632L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001729923",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Mickowski, CRNP
• Allison Middleton, LSW
• Eileen Catherine Miller, OTR/L
• Jennifer Christine Miller, COTA
• Lucia Miller, LSW
• Sharon K. Miller, P.T.
• Amy L Minnich, LCSW
• Arthur B Mitchell, MD
• Brian Mitchell, DDS
• Basant Kumar Mittal, M.D.

• General Practice Physician in Kingston, PA
• Providers in Kingston, PA by specialty
• General Practice Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.