Active NPI
Mark Daniel Miller, M.D.
- Surgery Physician
- Lexington, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 58412
- Practice address
- 1221 S Broadway
Lexington, KY 40504-2701 - Phone
- (859) 258-4271
- Fax
- (859) 258-4418
- NPI assigned
- Apr 22, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 28222 | WV | |
| Surgery Physician | 208600000X | TP657 | KY | |
| Surgery Physician | 208600000X | 58412 | KY | Primary |
Addresses
Primary practice location
1221 S Broadway
Lexington, KY 40504-2701
Mailing address
1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100440870 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- West Virginia University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000
Hospital & facility affiliations
- Saint Joseph Hospital
- Saint Joseph Mount Sterling
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 14 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TP657 | KY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Hospital Center, Inc | Current | Accepting new patients | |
| New Lexington Clinic, PSC | Current | Accepting new patients | |
| New Lexington Clinic PSC | Current | Accepting new patients | |
| United Hospital Center, Inc. | Surgery | Current | Accepting new patients |
Locations
1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181
527 Medical Park Dr
Ste 202
Bridgeport, WV 26330
Phone (304) 933-3850
916 W Main St
Bridgeport, WV 26330
Phone (304) 842-1034
327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000
527 Medical Park Dr
Ste 400
Bridgeport, WV 26330
Phone (681) 342-1610
2673 Davisson Run Rd
Ste 303
Clarksburg, WV 26301
Interoperability endpoints
- mark.miller.1@13059.direct.athenahealth.com
- mmiller12809@direct.wvuhsdirect.com
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Lexington, KY
- NPI 1700803681
-
- Clinical Medical Laboratory
- Lexington, KY
- NPI 1285409425
-
- Urology Physician
- Bridgeport, WV
- NPI 1023337193
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lexington, KY
- NPI 1437150984
-
- General Acute Care Hospital
- Mt Sterling, KY
- NPI 1679679146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1265876106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 S BROADWAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405042701",
"telephone_number": "859-258-6200",
"fax_number": "859-258-6203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 S BROADWAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405042701",
"telephone_number": "859-258-4271",
"fax_number": "859-258-4418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MARK",
"middle_name": "DANIEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-22",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WV",
"license": "28222",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "TP657",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "58412",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100440870",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.