Individual provider Active NPI

Teresa Beth Miller, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1316258247
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1699 Issued in OK
Practice address
4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618
Phone
(405) 378-2727
NPI assigned
Jun 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1699 OK Primary

Addresses

Primary practice location

4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618

Mailing address

4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618
Phone (405) 378-2727

Other practice location 1

1105 SW 30th Ct
Moore, OK 73160-2887
Phone (405) 378-2727

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110919000287 OK Practitioner - Physician Assistant 5698946929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balance Womens Health LLCGroup PAC ID 3476927740, 89 clinicians

Practice addresses (Care Compare)

1105 SW 30TH CT
Moore, OK 73160-2887
Phone (405) 378-2727

1113 SW 30TH CT
Moore, OK 73160-2887
Phone (405) 378-2727

4013 NW Expressway
Suite 105
Oklahoma City, OK 73116-2618
Phone (405) 378-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1699OKMDPhysician Assistant

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CACJCA/Endpoint/CACJCA
  • Direct secure messaging: lifestancehealth.teresamiller@148561.advancedmd-direct.com

Organizations & group practices 1

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1316258247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4013 NW EXPRESSWAY STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731162618",
            "telephone_number": "405-378-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 NW EXPRESSWAY STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731162618",
            "telephone_number": "405-378-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 SW 30th Ct",
            "address_purpose": "LOCATION",
            "city": "Moore",
            "state": "OK",
            "postal_code": "731602887",
            "country_code": "US",
            "telephone_number": "405-378-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TERESA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.