Individual provider Active NPI

Lynn D Miller, MD

  • Anesthesiology Physician
  • Boulder, CO
National Provider Identifier
1508896192
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
29040 Issued in CO
Practice address
1100 Balsam Ave
Boulder, CO 80304-3404
Phone
(303) 440-2092
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 29040 CO Primary

Addresses

Primary practice location

1100 Balsam Ave
Boulder, CO 80304-3404

Mailing address

PO Box 668
Arvada, CO 80001-0668
Phone (303) 422-9438

Other identifiers 1

IdentifierTypeStateIssuer
01290402MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20110412000936 CO Practitioner - Anesthesiology 3274717434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loma Linda University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Valley Anesthesiology, PLLCGroup PAC ID 7113830993, 61 clinicians

Practice addresses (Care Compare)

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-7000

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29040COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Valley Anesthesiology, PLLC Anesthesiology CurrentSince Jun 1, 2001 Accepting new patients

Locations

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

1100 Balsam Ave
Boulder, CO 80304
Phone (303) 415-7000

4450 Arapahoe Ave
Ste 100
Boulder, CO 80303
Phone (303) 415-2532

10170 Church Ranch Way
Westminster, CO 80021
Phone (303) 328-3400

Organizations & group practices 1

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 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1508896192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800010668",
            "telephone_number": "303-422-9438",
            "fax_number": "303-422-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BALSAM AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043404",
            "telephone_number": "303-440-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LYNN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "29040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01290402",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.