Robert Newell Miller IV, MD

Key facts

NPI: 1528099876
Entity type: Individual (NPI type 1)
Primary specialty: Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
License: 54201-020 (WI)
Practice address: 11101 N Sherman Rd
Edgerton, WI 53534-9002
Phone: (608) 884-1600
NPI assigned: Jul 5, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 3

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.

Edgerton Hospital and Health Services Inc. Critical Access Hospital · Edgerton, WI · NPI 1154350049

Medicare reassignment NPD WI
Edgerton Hospital and Health Services, Inc Urgent Care Clinic/Center · Whitewater, WI · NPI 1982496295

NPD
Holy Family Medical Center Anesthesiology Physician · Des Plaines, IL · NPI 1356556468

NPD (past)

Medicare Care Compare profile

Merit-based Incentive Payment System (MIPS)

Final score: 69.34 of 100 (group)
Quality: 87.81
Promoting interoperability: 100
Improvement activities: 40
Cost: 10

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20100415000790	WI	Practitioner - Emergency Medicine	8022910579	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
54201-020	WI	MD	Emergency Medical Services (Emergency Medicine) Physician

Practice roles

Organization	Status	New patients
Edgerton Hospital and Health Services, Inc	Current since Dec 23, 2014	Accepting new patients
Edgerton Hospital and Health Services Inc.	Current since Dec 23, 2014	Accepting new patients
Holy Family Medical Center	Past	Accepting new patients

Locations

11101 N Sherman Rd
Edgerton, WI 53534
Phone (608) 884-1695

831 Arthur Dr
Milton, WI 53563
Phone (608) 868-3526

Interoperability endpoints

Direct secure messaging: rmiller261909@direct-ehr-ssmhc.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Emergency Medical Services (Emergency Medicine) Physician	207PE0004X	54201-020	WI	Yes

Addresses

Primary practice location

11101 N Sherman Rd
Edgerton, WI 53534-9002

Mailing address

11101 N Sherman Rd
Edgerton, WI 53534-9002
Phone (608) 884-1600

Other practice location 1

915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 652-4100

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 10, 2024.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1528099876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11101 N SHERMAN RD",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535349002",
            "telephone_number": "608-884-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 N SHERMAN RD",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535349002",
            "telephone_number": "608-884-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 N Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631061621",
            "country_code": "US",
            "telephone_number": "314-652-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROBERT",
        "middle_name": "NEWELL",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "54201-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgerton, WI

All providers in Edgerton, WI · Emergency Medical Services (Emergency Medicine) Physician in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.