Individual provider Active NPI

Lawrence S Miller, MD

  • Orthopaedic Surgery Physician
  • Glassboro, NJ
National Provider Identifier
1447337183
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MA74564 Issued in NJ
Practice address
221 Victoria St
Glassboro, NJ 08028-2278
Phone
(856) 536-1475
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MA74564 NJ Primary

Addresses

Primary practice location

221 Victoria St
Glassboro, NJ 08028-2278

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

6117 Main St
Voorhees, NJ 08043-4660
Phone (856) 325-6677

Other identifiers 11

IdentifierTypeStateIssuer
2130421000OtherNJAMERIHEALTH/KEYSTON/IBC
0052412000OtherPAKEYSTONE/IBC
010004388OtherNJAMERICHOICE
2937750OtherNJAETNA
42384OtherNJUNIVERSITY HEALTH PLAN
8939403MedicaidNJ
3K5446OtherNJHEALTHNET
1447021OtherNJAMERIHEALTH PPO/BLUE SHIELD
1072456OtherNJCIGNA
426719OtherNJUNITED HEALTHCARE
P395850OtherNJOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050728000625 NJ Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 3375571680 Reassigns benefits to 1 organization
I20120710000032 PA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 3375571680

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA74564NJMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Cooper Obstetrical Associates, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lmiller1934@direct.cooperhealth.edu

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1447337183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 VICTORIA ST",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282278",
            "telephone_number": "856-536-1475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6117 Main St",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080434660",
            "country_code": "US",
            "telephone_number": "856-325-6677",
            "fax_number": "856-325-6678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LAWRENCE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "MA74564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/KEYSTON/IBC",
            "identifier": "2130421000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE/IBC",
            "identifier": "0052412000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "010004388",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2937750",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH PLAN",
            "identifier": "42384",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8939403",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K5446",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO/BLUE SHIELD",
            "identifier": "1447021",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1072456",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "426719",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P395850",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glassboro, NJ

Sources for this page

Verify at the official NPI Registry.