Individual provider Active NPI

John K. Miller, M.D.

  • Diagnostic Radiology Physician
  • Beaumont, TX
National Provider Identifier
1467457796
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
J0777 Issued in TX
Practice address
3560 Delaware St
209
Beaumont, TX 77706-3059
Phone
(409) 899-3682
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X J0777 TX Primary

Addresses

Primary practice location

3560 Delaware St
209
Beaumont, TX 77706-3059

Mailing address

3560 Delaware St
209
Beaumont, TX 77706-3059
Phone (409) 899-3682

Other identifiers 1

IdentifierTypeStateIssuer
124863503MedicaidTX

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110822000251 TX Practitioner - Diagnostic Radiology 9032287107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Baylor College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Radiology AssociatedGroup PAC ID 8022092451, 107 clinicians

Practice addresses (Care Compare)

6565 Fannin St
Houston, TX 77030-2703
Phone (281) 206-9020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.75 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Radiology Associated Diagnostic Radiology CurrentSince Jan 1, 2021 Accepting new patients
Crawford Andrews & Davis PTR Diagnostic Radiology CurrentSince May 14, 1992 Accepting new patients

Locations

755 N 11th St
Ste P3970B
Beaumont, TX 77702
Phone (409) 924-3996

2830 Calder St
Beaumont, TX 77702
Phone (409) 899-7000

3560 Delaware St
Ste 209
Beaumont, TX 77706
Phone (409) 239-0971

18500 Katy Fwy
Houston, TX 77094
Phone (281) 206-9020

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1467457796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST",
            "address_2": "209",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063059",
            "telephone_number": "409-899-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST",
            "address_2": "209",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063059",
            "telephone_number": "409-899-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOHN",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J0777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124863503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.