Individual provider Active NPI

Paul Andrew Miller, M.D.

  • Hospitalist Physician
  • Evanston, IL
National Provider Identifier
1356357792
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036086503 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1700
Phone
(847) 570-2833
Fax
(847) 570-1510
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-086503 IL
Hospitalist Physician 208M00000X 036086503 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Evanston, IL 60201-1700

Mailing address

2650 Ridge Ave
Evanston, IL 60201-1700
Phone (847) 570-2833

Other practice location 1

2545 S King Dr
Chicago, IL 60616-2441
Phone (312) 842-7117

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmiller275972@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100205000546 IL Practitioner - Pediatric MedicinePractitioner - Hospitalist 2567505076 Reassigns benefits to 2 organizations
I20200629000145 IL Practitioner - HospitalistPractitioner - Pediatric Medicine 2567505076 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-086503ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Covenant Management Services, Inc. Pediatrics CurrentSince Aug 1, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics CurrentSince Jan 1, 2014 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jan 1, 2014 Accepting new patients
Endeavor Health Medical Group Pediatrics Current Accepting new patients
Endeavor Health Medical Group CurrentSince Jun 11, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Aug 1, 2020 Accepting new patients

Locations

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

5140 N California Ave
Chicago, IL 60625
Phone (773) 275-8811

9532 Eagle Way
Chicago, IL 60678

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

2740 W Foster Ave
Ste LL7
Chicago, IL 60625

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

777 Park Ave W
Highland Park, IL 60035
Phone (847) 480-3744

Interoperability endpoints

  • Direct secure messaging: pmiller275972@direct.northshore.org
  • Direct secure messaging: pmiller17303@uihealth.direct-ci.com

Organizations & group practices 7

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1356357792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2833",
            "fax_number": "847-570-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2833",
            "fax_number": "847-570-1510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2545 S King Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606162441",
            "country_code": "US",
            "telephone_number": "312-842-7117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "PAUL",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-086503",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036086503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmiller275972@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2650 Ridge Ave",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602011700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.