Individual provider Active NPI

Marjorie S. Miller, M.D.

  • Surgery Physician
  • Medford, WI
National Provider Identifier
1487687604
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
44424 Issued in WI
Practice address
143 S Gibson St
Medford, WI 54451-1622
Phone
(715) 748-2121
NPI assigned
Jul 9, 2006
Last updated
Dec 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35406 WI
Surgery Physician 208600000X 44424 WI Primary

Addresses

Primary practice location

143 S Gibson St
Medford, WI 54451-1622

Mailing address

225811 Bayview Dr
Wisconsin Rapids, WI 54494-4714

Other practice location 1

420 Dewey St
Wisconsin Rapids, WI 54494-4714
Phone (715) 422-7771

Other practice location 2

3400 E Racine St
Janesville, WI 53546-2344
Phone (608) 373-8000

Other identifiers 2

IdentifierTypeStateIssuer
34220700MedicaidWI
1487687604MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address mmiller441903@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 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
I20051207000376 WI Practitioner - General Surgery 3577583418 Reassigns benefits to 9 organizations
I20241009000736 MN Practitioner - General Surgery 3577583418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians
Aspirus Medford Hospital and Clinics IncGroup PAC ID 5799688602, shared by 9 NPIs, 126 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

143 S Gibson St
Medford, WI 54451-1622
Phone (715) 748-8100

410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone (715) 423-6060

824 Illinois Ave
Stevens Point, WI 54481-3112
Phone (715) 344-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35406WIMDSurgery Physician
44424WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Jul 25, 2023 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Dec 28, 2023 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jan 8, 2024 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Aug 4, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Jan 8, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jan 8, 2024 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Jan 12, 2023 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Dec 28, 2023 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jul 25, 2023 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Jan 20, 2023 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Jan 8, 2024 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Agnesian Healthcare Inc Surgery CurrentSince Jan 12, 2023 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Jan 20, 2023 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Aug 4, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

3400 E Racine St
Janesville, WI 53546
Phone (608) 373-8000

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

143 S Gibson St
Medford, WI 54451
Phone (715) 748-2121

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

845 Parkside St
Ripon, WI 54971
Phone (920) 748-3101

824 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

420 Dewey St
#2
Wisconsin Rapids, WI 54494
Phone (715) 422-7771

420 Dewey St
Ste 2
Wisconsin Rapids, WI 54494
Phone (715) 422-7771

Interoperability endpoints

  • Direct secure messaging: mmiller17288@direct.aspirus.org
  • Direct secure messaging: mmiller827441@direct.centracare.com

Organizations & group practices 24

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 24

Hospital & facility affiliations 6

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1487687604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225811 BAYVIEW DR",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544944714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S GIBSON ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511622",
            "telephone_number": "715-748-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Dewey St",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544944714",
            "country_code": "US",
            "telephone_number": "715-422-7771",
            "fax_number": "715-424-4404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 E Racine St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535462344",
            "country_code": "US",
            "telephone_number": "608-373-8000",
            "fax_number": "608-373-8795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARJORIE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "35406",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "44424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34220700",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487687604",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3400 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmiller441903@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mmiller441903@direct-ehr-ssmhc.com",
            "address_1": "3400 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, WI

Sources for this page

Verify at the official NPI Registry.