Active NPI
Jordan Paul Miller
- Physician Assistant
- Renton, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1205 N 10TH St
Renton, WA 98057-5577 - Phone
- (425) 656-4211
- Fax
- (425) 656-4053
- NPI assigned
- Mar 24, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1205 N 10TH St
Renton, WA 98057-5577
Mailing address
PO Box 34876
Seattle, WA 98124-1876
Phone (425) 656-5412
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12040 NE 128TH St
Kirkland, WA 98034-3013
12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013
12710 Totem Lake Blvd NE
Kirkland, WA 98034-2907
Phone (425) 821-4040
14841 179TH Ave SE
Monroe, WA 98272-1127
16916 140TH Ave NE
Woodinville, WA 98072-6957
1909 214TH St SE
Suite 110
Bothell, WA 98021-4412
Phone (425) 488-4988
4220 132ND St SE
Suite 103
Mill Creek, WA 98012-8999
Phone (425) 225-1210
8980 161St Ave NE
Redmond, WA 98052-7554
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| King County Public Hospital District No. 2 | Current | Accepting new patients | |
| King County Public Hospital District No 2 | Current | Accepting new patients |
Locations
1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988
12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000
Organizations & group practices 4
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.
-
- Neuromusculoskeletal Medicine & OMM Physician
- Kirkland, WA
- NPI 1801986070
-
- General Acute Care Hospital
- Renton, WA
- NPI 1619209574
-
- Family Medicine Physician
- Bothell, WA
- NPI 1902907165
-
- Physical Therapist
- Kirkland, WA
- NPI 1356920946
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kirkland, WA
- NPI 1033174933
-
- General Acute Care Hospital
- Monroe, WA
- NPI 1013074061
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Monroe, WA
- NPI 1770614273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478217600000",
"number": "1396107728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34876",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241876",
"telephone_number": "425-656-5412",
"fax_number": "425-656-4096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 N 10TH ST",
"city": "RENTON",
"state": "WA",
"postal_code": "980575577",
"telephone_number": "425-656-4211",
"fax_number": "425-656-4053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JORDAN",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-24",
"last_updated": "2016-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.