Individual provider Active NPI

Derrick Lloyd Miller, MD

  • Sports Medicine (Family Medicine) Physician
  • Antioch, CA
National Provider Identifier
1366022386
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
A202679 Issued in CA
Practice address
4501 Sand Creek Rd
Antioch, CA 94531-8687
Phone
(408) 357-1410
NPI assigned
Apr 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A202679 CA
Sports Medicine (Family Medicine) Physician 207QS0010X A202679 CA Primary

Addresses

Primary practice location

4501 Sand Creek Rd
Antioch, CA 94531-8687

Mailing address

4501 Sand Creek Rd
Antioch, CA 94531-8687
Phone (925) 813-6500

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250530001606 CA Practitioner - Family Practice 3678082807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

50 E Hamilton Ave
Suite 200
Campbell, CA 95008-0251
Phone (408) 357-1425

Hospital & facility affiliations

  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A202679CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Alliance CurrentSince Jul 1, 2025 Accepting new patients
Affinity Medical Group Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 120
Campbell, CA 95008
Phone (408) 357-1410

50 E Hamilton Ave
Ste 200
Campbell, CA 95008
Phone (408) 376-2300

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

455 Oconnor Dr
Ste 210
San Jose, CA 95128
Phone (408) 831-5744

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.

Hospital & facility affiliations 7

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1366022386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 SAND CREEK RD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318687",
            "telephone_number": "925-813-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 SAND CREEK RD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318687",
            "telephone_number": "408-357-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DERRICK",
        "middle_name": "LLOYD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A202679",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A202679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4501 Sand Creek Rd",
            "city": "Antioch",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945318687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.