Organization Active NPI

Jerry W. Miller, M.D., P.a.

  • Cardiovascular Disease Physician
  • El Paso, TX
National Provider Identifier
1295989127
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
H1626 Issued in TX
Legal business name
JERRY W. MILLER, M.D., P.A.
Practice address
1330 E. Yandell Drive
El Paso, TX 79902-5529
Phone
(915) 225-0410
Fax
(915) 225-0419
NPI assigned
Nov 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Dr. Jerry Winkler Miller, M.D.NPI 1811936511
Title
President
Phone
(915) 225-0410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X H1626 TX Primary

Addresses

Primary practice location

1330 E. Yandell Drive
El Paso, TX 79902-5529

Mailing address

1330 E Yandell Dr
El Paso, TX 79902-5529
Phone (915) 225-0410

Other identifiers 1

IdentifierTypeStateIssuer
205129401MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090121000426 TX Part B Supplier - Clinic/Group Practice 2769546670 Receives reassigned benefits from 2 practitioners
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Locations

1330 E Yandell Dr
El Paso, TX 79902
Phone (915) 225-0410

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11036/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1295989127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 E YANDELL DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799025529",
            "telephone_number": "915-225-0410",
            "fax_number": "915-225-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 E. YANDELL DRIVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799025529",
            "telephone_number": "915-225-0410",
            "fax_number": "915-225-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY W. MILLER, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "WINKLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "915-225-0410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "H1626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205129401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.