Individual provider Active NPI

Joseph B Miller

  • Physician Assistant
  • Petaluma, CA
National Provider Identifier
1427398155
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
599 Tomales Rd
Petaluma, CA 94952-5002
Phone
(707) 765-7200
NPI assigned
Feb 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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 Primary

Addresses

Primary practice location

599 Tomales Rd
Petaluma, CA 94952-5002

Mailing address

599 Tomales Rd
Petaluma, CA 94952-5002
Phone (707) 765-7200

Other practice location 1

2401 Hawkins Point Rd
Baltimore, MD 21226-1797
Phone (410) 636-7506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1360972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1427398155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 TOMALES RD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949525002",
            "telephone_number": "707-765-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 TOMALES RD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949525002",
            "telephone_number": "707-765-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Hawkins Point Rd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212261797",
            "country_code": "US",
            "telephone_number": "410-636-7506",
            "fax_number": "410-636-7868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOSEPH",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-16",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.