Colleen Miller, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704233398 Issued in MI

Practice address

17000 E 10 Mile Rd
Eastpointe, MI 48021-1263

Phone

(586) 563-5555

Fax

(586) 563-1778

NPI assigned

May 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Primary Care PLLCGroup PAC ID 4486846250, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Residential Home Health Home health agency, Troy, MI, CCN 237459
• Optimal Care Home Health Home health agency, Bingham Farms, MI, CCN 237504
• Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Michigan Primary Care PLLC

  • Specialist
  • Sterling Heights, MI
  • NPI 1669799128
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Optimal Care, LLC

  • Home Health Agency
  • Bingham Farms, MI
  • NPI 1588697841
  Care Compare affiliation
• Residential Home Health, LLC

  • Home Health Agency
  • Troy, MI
  • NPI 1992768550
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1285161430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41400 DEQUINDRE RD STE 121",
            "city": "STERLING HTS",
            "state": "MI",
            "postal_code": "483143751",
            "telephone_number": "586-843-3815",
            "fax_number": "586-843-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 E 10 MILE RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211263",
            "telephone_number": "586-563-5555",
            "fax_number": "586-563-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41400 Dequindre Rd Ste 121",
            "address_purpose": "LOCATION",
            "city": "Sterling Hts",
            "state": "MI",
            "postal_code": "483143751",
            "country_code": "US",
            "telephone_number": "586-843-3815",
            "fax_number": "586-843-3815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "COLLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704233398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "4704233398",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan Denture & Implant Center PC
• Michigan Orthopedic Services LLC
• Joseph Charles Mifsud, MA, LLP
• Millenium Pain Management & Therapy
• Adam Ryan Miller, D.C.
• Carrie Mitchell
• Tiffany Mitchell
• Modern Medical Pharmacy Inc
• Molar City Dental PLLC
• Anthony Montella, OD

• Gerontology Nurse Practitioner in Eastpointe, MI
• Providers in Eastpointe, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.

Verify at the official NPI Registry.