Individual provider Active NPI

Amanda Lucretia Miller, DMSC, PA-C

  • Physician Assistant
  • North Chesterfield, VA
National Provider Identifier
1366935132
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
110006260 Issued in VA
Practice address
2711 Buford Rd Ste 122
North Chesterfield, VA 23235-2423
Phone
(470) 610-1342
NPI assigned
Jun 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 110006260 VA Primary

Addresses

Primary practice location

2711 Buford Rd Ste 122
North Chesterfield, VA 23235-2423

Mailing address

2711 Buford Rd Ste 122
North Chesterfield, VA 23235-2423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA, TX, GA, CA, MD, MO7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20211005000509 TN Practitioner - Physician Assistant 5496153546
I20221010001503 VA Practitioner - Physician Assistant 5496153546 Reassigns benefits to 2 organizations
I20221102000491 TX Practitioner - Physician Assistant 5496153546 Reassigns benefits to 2 organizations
I20230609001439 GA Practitioner - Physician Assistant 5496153546 Reassigns benefits to 1 organization
I20230803000748 CA Practitioner - Physician Assistant 5496153546 Reassigns benefits to 5 organizations
I20230817003269 MD Practitioner - Physician Assistant 5496153546 Reassigns benefits to 1 organization
I20230914003714 MO Practitioner - Physician Assistant 5496153546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4562TNMDSpeech-Language Pathologist
110006260VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Sep 1, 2023 Accepting new patients
University of California San Francisco CurrentSince Jul 11, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 11, 2023 Accepting new patients
University of California San Francisco CurrentSince Jul 11, 2023 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

Interoperability endpoints

  • Direct secure messaging: thrivinglanellc.amandalmiller@149897.advancedmd-direct.com
  • Direct secure messaging: amiller305686@direct-ucsfmedicalcenter.org
  • Direct secure messaging: amiller448905@direct-ehr-ssmhc.com

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1366935132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 BUFORD RD STE 122",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232352423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 BUFORD RD STE 122",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232352423",
            "telephone_number": "470-610-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "AMANDA",
        "middle_name": "LUCRETIA",
        "credential": "DMSC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "110006260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.