Individual provider Active NPI

Lee Patrick Miller, MD

  • Plastic and Reconstructive Surgery Physician
  • Sioux Falls, SD
National Provider Identifier
1285613331
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
4092 Issued in SD
Practice address
4201 South Minnesota Avenue
Ste 112
Sioux Falls, SD 57105-6706
Phone
(605) 335-3349
Fax
(605) 336-8436
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 4092 SD Primary

Addresses

Primary practice location

4201 South Minnesota Avenue
Ste 112
Sioux Falls, SD 57105-6706

Mailing address

4201 South Minnesota Avenue
Ste 112
Sioux Falls, SD 57105-6706
Phone (605) 335-3349

Other identifiers 5

IdentifierTypeStateIssuer
0919563MedicaidIA
124216400MedicaidMN
10025286300MedicaidNE
240005059OtherRAILROAD MEDICARE
7301460MedicaidSD

Other names 1

  • L. Patrick Miller Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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

Enrollment IDStateProvider typePAC IDDetails
I20050809001126 SD Practitioner - Plastic and Reconstructive Surgery 9234168337 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Plastic Surgery Associates of South Dakota, LTD CurrentSince Jul 1, 2005 Accepting new patients
Upper Midwest Medical Inc CurrentSince Jan 4, 2020 Accepting new patients

Locations

911 E 20th St
Ste 602
Sioux Falls, SD 57105
Phone (605) 335-3346

4201 S Minnesota Ave
Ste 112
Sioux Falls, SD 57105
Phone (602) 232-9720

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1285613331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SOUTH MINNESOTA AVENUE",
            "address_2": "STE 112",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056706",
            "telephone_number": "605-335-3349",
            "fax_number": "605-336-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SOUTH MINNESOTA AVENUE",
            "address_2": "STE 112",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056706",
            "telephone_number": "605-335-3349",
            "fax_number": "605-336-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LEE",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "SD",
            "license": "4092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0919563",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124216400",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025286300",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "240005059",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301460",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "L.",
            "last_name": "MILLER",
            "middle_name": "PATRICK",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.