Larissa Kaye Miller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06352 Issued in TX

Practice address

17510 W Grand Pkwy S Ste 220
Sugar Land, TX 77479-2647

Phone

(281) 201-1338

Fax

(281) 201-1353

NPI assigned

Feb 24, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Larissa Kaye Cleveland Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lmiller45586@direct.kelsey-seybold.com

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.

• Kelsey-Seybold Medical Group, PLLC

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255
  Medicare reassignment
• Universal Surgical Assistants Inc.

  • Surgical Technologist
  • Sugar Land, TX
  • NPI 1215220116
  Medicare reassignment
• Central Surgical Support, LLC

  • Surgical Physician Assistant
  • Missouri City, TX
  • NPI 1053648543
  NPD (past)
• Memorial Hermann Medical Group

  • Family Medicine Physician
  • Fulshear, TX
  • NPI 1003985102
  NPD (past)
• Sienna Practitioners PLLC

  • Surgical Physician Assistant
  • Missouri City, TX
  • NPI 1750741047
  NPD (past)

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1356663827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17510 W GRAND PKWY S STE 220",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792647",
            "telephone_number": "281-201-1338",
            "fax_number": "281-201-1353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2727 W Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770251669",
            "country_code": "US",
            "telephone_number": "713-442-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22121 Fm 1093 Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774072140",
            "country_code": "US",
            "telephone_number": "713-442-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "929 Gessner Rd Ste 1450",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770242317",
            "country_code": "US",
            "telephone_number": "713-442-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LARISSA",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-24",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "PA06352",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARISSA",
            "last_name": "CLEVELAND",
            "middle_name": "KAYE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bruno Mier Castedo
• Larisa Mikhaylov
• Millennium Health Services Inc.
• Millennium RX, LLC
• George G Miller, MD
• Matthew T. Miller, M.ED. LPC
• Michael Miller
• Rosalyn G Miller, DO
• Tracey Miller, PA
• Yarinika M. Miller, LPC

• Physician Assistant in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.