Active NPI
Kyle Miller, M.D.
- Orthopaedic Surgery Physician
- Saint Paul, MN
National Provider Identifier
1477917813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 71272
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1477917813 | WI | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gillette Children'S Specialty Healthcare | Current | Accepting new patients | |
| Gillette Children'S Specialty Healthcare | Current | Accepting new patients | |
| Gillette Children'S Specialty Healthcare | Past | 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.
-
- Multi-Specialty Clinic/Center
- St. Paul, MN
- NPI 1225119175
-
- Multi-Specialty Clinic/Center
- Saint Cloud, MN
- NPI 1982090528
-
- Children's Hospital
- Saint Paul, MN
- NPI 1629161781
-
- Institutional Pharmacy
- Saint Paul, MN
- NPI 1386758373
-
- Children's Hospital
- Saint Paul, MN
- NPI 1447352836
-
- Orthopaedic Surgery Physician
- Germantown, TN
- NPI 1881387330
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.