Individual provider Active NPI

Douglas T Miller, M.D.

  • Gastroenterology Physician
  • Meriden, CT
National Provider Identifier
1326062464
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
028917 Issued in CT
Practice address
455 Lewis Ave
Suite 106
Meriden, CT 06451-2121
Phone
(203) 886-0036
Fax
(203) 886-0072
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 028917 CT
Gastroenterology Physician 207RG0100X 028917 CT Primary

Addresses

Primary practice location

455 Lewis Ave
Suite 106
Meriden, CT 06451-2121

Mailing address

2139 Silas Deane Hwy
Rocky Hill, CT 06067-2336
Phone (860) 257-4131

Other identifiers 1

IdentifierTypeStateIssuer
001289174MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20061013000394 CT Practitioner - GastroenterologyPractitioner - Internal Medicine 5092628743 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028917CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Gi PLLC Internal Medicine CurrentSince Sep 1, 2011 Accepting new patients
Litchfield County Gastroenterology Associates, LLC Gastroenterology PastSince Sep 1, 2011 Accepting new patients

Locations

85 Seymour St
Ste 1000
Hartford, CT 06106
Phone (860) 246-2571

455 Lewis Ave
Ste 200
Meriden, CT 06451
Phone (203) 238-9446

30 Waterchase Dr
Rocky Hill, CT 06067
Phone (860) 257-4131

850 N Main Street Ext
Ste 2B3
Wallingford, CT 06492
Phone (203) 886-0036

67 Masonic Ave
Ste 3100
Wallingford, CT 06492
Phone (203) 284-3144

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1326062464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 SILAS DEANE HWY",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672336",
            "telephone_number": "860-257-4131",
            "fax_number": "860-257-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 LEWIS AVE",
            "address_2": "SUITE 106",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512121",
            "telephone_number": "203-886-0036",
            "fax_number": "203-886-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DOUGLAS",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "028917",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "028917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001289174",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.