Individual provider Active NPI

Kyle Miller, M.D.

  • Orthopaedic Surgery Physician
  • Saint Paul, MN
National Provider Identifier
1477917813
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
71272 Issued in MN
Practice address
200 University Ave E
Saint Paul, MN 55101-2507
Phone
(651) 291-2848
NPI assigned
Apr 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 1477917813 WI
Orthopaedic Surgery Physician 207X00000X 71272 MN Primary

Addresses

Primary practice location

200 University Ave E
Saint Paul, MN 55101-2507

Mailing address

200 University Ave E
Saint Paul, MN 55101-2507

Other practice location 1

2639 University Ave
UW Office of GME
Madison, WI 53705-3750
Phone (608) 263-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20221017000821 MN Practitioner - Orthopedic Surgery 0749572626 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1477917813WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Children'S Specialty Healthcare CurrentSince Sep 12, 2022 Accepting new patients
Gillette Children'S Specialty Healthcare CurrentSince Sep 12, 2022 Accepting new patients
Gillette Children'S Specialty Healthcare PastSince Sep 23, 2021 Accepting new patients
CC Bpci PLC Orthopaedic Surgery Past Accepting new patients
Gillette Children'S Specialty Healthcare Past Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

200 University Ave E
#10614
Saint Paul, MN 55101

Organizations & group practices 6

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": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1477917813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507",
            "telephone_number": "651-291-2848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2639 University Ave",
            "address_2": "UW Office of GME",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537053750",
            "country_code": "US",
            "telephone_number": "608-263-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KYLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-12",
        "last_updated": "2023-03-15",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "1477917813",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "71272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.