Individual provider Active NPI

Alexander Miller, M.D.

  • Dermatology Physician
  • Yorba Linda, CA
National Provider Identifier
1437157179
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G42379 Issued in CA
Practice address
17451 Bastanchury Rd. Suite 103a
Yorba Linda, CA 92886-1871
Phone
(714) 961-0143
Fax
(714) 961-0265
NPI assigned
Jul 7, 2005
Last updated
Aug 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G42379 CA Primary
MOHS-Micrographic Surgery Physician 207ND0101X G42379 CA

Addresses

Primary practice location

17451 Bastanchury Rd. Suite 103a
Yorba Linda, CA 92886-1871

Mailing address

17451 Bastanchury Rd. Suite 103a
Yorba Linda, CA 92886-1871
Phone (714) 961-0143

Other identifiers 1

IdentifierTypeStateIssuer
3162518MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091211000186 CA Practitioner - Dermatology 2668512344 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, Irvine, California College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uci Department of DermatologyGroup PAC ID 7113920992, 38 clinicians
Newport Beach Surgical and Medical Group IncGroup PAC ID 3577784750, 11 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

17451 Bastanchury Rd
Suite 103a
Yorba Linda, CA 92886-1871
Phone (714) 961-0265

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.57 of 100Reported as group
Quality
77.27
Promoting interoperability
99
Improvement activities
40
Cost
38.81

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision37
Removal of tissue1-10
Removal of skin lesions805
Removal of skin cancer117
Removal or shaving of skin growth1-10
Skin biopsy210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G42379CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Beach Surgical and Medical Group Inc Dermatology CurrentSince Jan 1, 2019 Accepting new patients
Uci Department of Dermatology Dermatology CurrentSince Feb 7, 2014 Accepting new patients
St Jude Hospital Inc Past Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

180 Newport Center Dr
Ste 158
Newport Beach, CA 92660
Phone (949) 209-1622

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

17451 Bastanchury Rd
Ste 103A
Yorba Linda, CA 92886
Phone (714) 961-0143

Interoperability endpoints

  • Direct secure messaging: alexander.miller.p1@direct.sms.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1437157179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17451 BASTANCHURY RD. SUITE 103A",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928861871",
            "telephone_number": "714-961-0143",
            "fax_number": "714-961-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17451 BASTANCHURY RD. SUITE 103A",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928861871",
            "telephone_number": "714-961-0143",
            "fax_number": "714-961-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G42379",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "G42379",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3162518",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

Verify at the official NPI Registry.