Individual provider Active NPI

Dirk Miller, L.P.

  • Clinical Psychologist
  • Saint Paul, MN
National Provider Identifier
1497824981
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP2537 Issued in MN
Practice address
2550 University Ave W
Suite 314N
Saint Paul, MN 55114-1052
Phone
(651) 645-5323
Fax
(651) 647-5135
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP2537 MN Primary

Addresses

Primary practice location

2550 University Ave W
Suite 314N
Saint Paul, MN 55114-1052

Mailing address

2550 University Ave W
Suite 314N
Saint Paul, MN 55114-1052
Phone (651) 645-5323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110419000275 WA Practitioner - Clinical Psychologist 2466350525 Reassigns benefits to 1 organization
I20120109000257 MN Practitioner - Clinical Psychologist 2466350525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emily Program P CGroup PAC ID 5193623254, shared by 2 NPIs, 49 clinicians

Practice addresses (Care Compare)

1700 Westlake Ave N
Suite 700
Seattle, WA 98109-3097
Phone (888) 364-5977

2265 Como Ave
Saint Paul, MN 55108-1737
Phone (651) 645-5323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Program P C CurrentSince Jan 15, 1997 Accepting new patients
Emily Program PC CurrentSince Apr 24, 2018 Accepting new patients

Locations

2265 Como Ave
Saint Paul, MN 55108

2230 Como Ave
Saint Paul, MN 55108
Phone (651) 635-0095

2550 University Ave W
Ste 314N
Saint Paul, MN 55114

673 Woodland Square Loop SE
Ste 330
Olympia, WA 98503
Phone (415) 710-6689

1700 Westlake Ave N
Ste 65
Seattle, WA 98109
Phone (206) 283-2220

1700 Westlake Ave N
Ste 700
Seattle, WA 98109
Phone (206) 283-2220

2020 E 29th Ave
Ste 200
Spokane, WA 99203
Phone (509) 252-1366

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497824981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 314N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-645-5323",
            "fax_number": "651-647-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 314N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-645-5323",
            "fax_number": "651-647-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DIRK",
        "credential": "L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.