Individual provider Active NPI

Justin Michael Miller I, O.D.

  • Optometrist
  • Columbus, OH
National Provider Identifier
1396173217
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6249 Issued in OH
Practice address
338 W 10TH Ave
Columbus, OH 43210-1280
Phone
(614) 292-2020
NPI assigned
Oct 31, 2013
Last updated
Oct 31, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6249 OH Primary

Addresses

Primary practice location

338 W 10TH Ave
Columbus, OH 43210-1280

Mailing address

338 W 10TH Ave
Columbus, OH 43210-1280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150325001974 OH Practitioner - Optometry 8123345402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optometric Management Group LLCGroup PAC ID 7517034291, 43 clinicians

Practice addresses (Care Compare)

265 N Liberty St
Powell, OH 43065-8870
Phone (614) 793-0700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6249OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Management Group LLC Optometrist CurrentSince Mar 1, 2023 Accepting new patients
Ohio State University Optometrist Past Accepting new patients
Ohio State University Past Accepting new patients

Locations

3636 Broadway
Grove City, OH 43123
Phone (614) 871-3234

3959 Hoover Rd
Grove City, OH 43123
Phone (614) 766-2006

265 N Liberty St
Powell, OH 43065
Phone (614) 793-0700

226 W Court St
Washington Court House, OH 43160
Phone (740) 335-2020

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1396173217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280",
            "telephone_number": "614-292-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-31",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.