Individual provider Active NPI

Bruce Miller, DPM

  • Foot & Ankle Surgery Podiatrist
  • Pasadena, TX
National Provider Identifier
1417045592
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0648 Issued in TX
Practice address
6021 Fairmont Pkwy
Ste 130
Pasadena, TX 77505-4022
Phone
(281) 991-0600
Fax
(281) 991-0638
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0648 TX Primary

Addresses

Primary practice location

6021 Fairmont Pkwy
Ste 130
Pasadena, TX 77505-4022

Mailing address

6021 Fairmont Pkwy
Ste 130
Pasadena, TX 77505-4022
Phone (281) 991-0600

Other identifiers 2

IdentifierTypeStateIssuer
0648OtherTXLICENSE
K0036113OtherTXDPS

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120302000115 TX Practitioner - Podiatry 1254233166 Reassigns benefits to 1 organization
Practice locations: Sugar Land, TX

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Foot Specialist IncGroup PAC ID 8527161728, 2 clinicians

Practice addresses (Care Compare)

13737 Southwest Fwy
Sugar Land, TX 77478-3531
Phone (281) 242-4448

6021 Fairmont Pkwy
Suite 130
Pasadena, TX 77505-4505
Phone (281) 991-0600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue100
Removal of skin lesions1-10
Removal of nail tissue79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0648TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Foot Specialist Inc Foot & Ankle Surgery CurrentSince May 31, 1991 Accepting new patients
Inpatient Consultants of Florida, Inc Past Accepting new patients
Associated Foot Specialist of Pearland Foot & Ankle Surgery Past Accepting new patients

Locations

6021 Fairmont Pkwy
Ste 130
Pasadena, TX 77505
Phone (281) 991-0600

3311 Broadway St
Pearland, TX 77581
Phone (281) 412-4950

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417045592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6021 FAIRMONT PKWY",
            "address_2": "STE 130",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775054022",
            "telephone_number": "281-991-0600",
            "fax_number": "281-991-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 FAIRMONT PKWY",
            "address_2": "STE 130",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775054022",
            "telephone_number": "281-991-0600",
            "fax_number": "281-991-0638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRUCE",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "0648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0648",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "K0036113",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.