NPIMap

Individual provider Active NPI

Thomas Lee Miller, M.D.

  • Family Medicine Physician
  • Angola, IN
National Provider Identifier
1326048802
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01033506A Issued in IN
Practice address
1500 W Maumee St
Angola, IN 46703-8605
Phone
(260) 665-8494
Fax
(260) 668-5690
NPI assigned
Jul 27, 2005
Last updated
Mar 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 200185720A IN
Family Medicine Physician 207Q00000X 01033506A IN Primary

Addresses

Primary practice location

1500 W Maumee St
Angola, IN 46703-8605

Mailing address

1500 W Maumee St
Angola, IN 46703-8605
Phone (260) 665-8494

Other identifiers 2

IdentifierTypeStateIssuer
100225670MedicaidIN
200185720AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090403000276 IN Practitioner - Family Practice 5294804928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cameron Memorial Community Hospital IncGroup PAC ID 9234020835, shared by 8 NPIs, 83 clinicians

Practice addresses (Care Compare)

1500 W Maumee St
Angola, IN 46703-8605
Phone (260) 667-5670

401 S Broad St
Suite D
Fremont, IN 46737-2114
Phone (260) 667-5685

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200185720AINMDRural Health Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Cameron Memorial Community Hospital Inc Rural Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tmiller8087@direct.parkviewexchange.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cameron Family Medicine - NorthAngola, IN, CCN 158570 Rural health clinic Corporate Officer Apr 25, 2023
Cameron Family Medicine FremontFremont, IN, CCN 158571 Rural health clinic Corporate Director Jan 1, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1326048802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467038605",
            "telephone_number": "260-665-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467038605",
            "telephone_number": "260-665-8494",
            "fax_number": "260-668-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "THOMAS",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IN",
            "license": "200185720A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01033506A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100225670",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200185720A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.