NPIMap

Individual provider Active NPI

Matthew Miller, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1487383147
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4846 Issued in OK
Practice address
5401 N Portland Ave Ste 600
Oklahoma City, OK 73112-2090
Phone
(405) 713-9940
Fax
(405) 713-9941
NPI assigned
Jun 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4846 OK Primary

Addresses

Primary practice location

5401 N Portland Ave Ste 600
Oklahoma City, OK 73112-2090

Mailing address

3001 Quail Springs Pkwy FL 5
Oklahoma City, OK 73134-2640
Phone (405) 713-9940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220812001012 OK Practitioner - Physician Assistant 2466835145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

1201 Health Ctr Pkwy
Yukon, OK 73099-6381
Phone (405) 717-6800

1608 Professional Cir
Yukon, OK 73099-6314
Phone (405) 494-9300

1651 Professional Cir
Yukon, OK 73099-6314
Phone (405) 350-6770

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

5401 N Portland Ave
Suite 540
Oklahoma City, OK 73112-2092
Phone (405) 727-3015

5401 N Portland Ave
Suite 600
Oklahoma City, OK 73112-2121
Phone (405) 713-9940

5501 N Portland
Select Specialty Hosp West
Oklahoma City, OK 73112-2074
Phone (405) 951-4016

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Integris Canadian Valley Hospital Hospital, Yukon, OK, CCN 370211
  • Integris Southwest Medical Center Hospital, Oklahoma City, OK, CCN 370106
  • Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4846OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Baptist Medical Center Inc Past Accepting new patients
St Mary'S Hospital and Medical Center, Inc Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Intermountain Medical Group Grand Junction, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmiller219366@direct.integrisok.com

Organizations & group practices 7

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 9

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": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1487383147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 QUAIL SPRINGS PKWY FL 5",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731342640",
            "telephone_number": "405-713-9940",
            "fax_number": "405-713-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N PORTLAND AVE STE 600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122090",
            "telephone_number": "405-713-9940",
            "fax_number": "405-713-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.