NPIMap

Individual provider Active NPI

Matthew David Miller, D.O.

  • Hematology & Oncology Physician
  • Joplin, MO
National Provider Identifier
1558474122
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2004030340 Issued in MO
Practice address
3415 McIntosh Cir
Joplin, MO 64804-3651
Phone
(417) 347-4000
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 2004030340 MO Primary

Addresses

Primary practice location

3415 McIntosh Cir
Joplin, MO 64804-3651

Mailing address

PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-4000

Other identifiers 1

IdentifierTypeStateIssuer
2004030340OtherMOPHYSICIAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061020000489 MO Practitioner - Hematology/Oncology 8820095516 Reassigns benefits to 2 organizations
I20081017000519 OK Practitioner - Hematology/Oncology 8820095516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Oklahoma State University College of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, shared by 14 NPIs, 385 clinicians

Practice addresses (Care Compare)

1001 E 18TH St
Integris Grove Hospital
Grove, OK 74344-2097
Phone (918) 786-2243

1102 W
32ND
Joplin, MO 64804-3503

1102 W 32 St
Joplin, MO 64804-3503

307 W 11TH St
Freeman Lamar Family Care
Lamar, MO 64759-1428
Phone (417) 682-3300

3401 McIntosh Cir
Suite 100
Joplin, MO 64804-3651
Phone (417) 347-7200

3415 McIntosh Cir
Joplin, MO 64804-3651
Phone (417) 347-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3869OKMDNeurology Chiropractor
2004030340MOMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman-Oak Hill Health System CurrentSince Apr 1, 2008 Accepting new patients
Freeman-Oak Hill Health System CurrentSince Jul 17, 2006 Accepting new patients
Integris Ambulatory Care Corporation CurrentSince Jan 1, 2017 Accepting new patients
Freeman-Oak Hill Health System CurrentSince Jul 17, 2006 Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients
Freeman-Oak Hill Health System Past Accepting new patients
Integris Grove Hospital Past Accepting new patients

Locations

3415 McIntosh Cir
Joplin, MO 64804
Phone (417) 347-4000

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

307 W 11th St
Lamar, MO 64759
Phone (417) 682-3300

1101 E 13th St
Grove, OK 74344
Phone (417) 347-3649

30 B St SW
Miami, OK 74354
Phone (918) 542-2273

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

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1558474122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810",
            "telephone_number": "417-347-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 MCINTOSH CIR",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043651",
            "telephone_number": "417-347-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MO",
            "license": "2004030340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "2004030340",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.