Individual provider Active NPI

Brandt Riley Miller, OD

  • Optometrist
  • Sugarcreek, OH
National Provider Identifier
1568156602
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007158 Issued in OH
Practice address
110 Andreas Dr NE
Sugarcreek, OH 44681-7503
Phone
(330) 852-2512
NPI assigned
Jun 2, 2023
Last updated
Jun 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007158 OH Primary

Addresses

Primary practice location

110 Andreas Dr NE
Sugarcreek, OH 44681-7503

Mailing address

6995 State Route 241
Millersburg, OH 44654-9469
Phone (330) 231-0505

Other practice location 1

4606 Township Road 634
Millersburg, OH 44660
Phone (330) 231-0505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719002585 OH Practitioner - Optometry 3274993449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Vision Care IncGroup PAC ID 0244302511, 7 clinicians

Practice addresses (Care Compare)

110 Andreas Dr NE
Suite a
Sugarcreek, OH 44681-7503
Phone (330) 852-2512

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007158OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Vision Care, Inc. Optometrist CurrentSince Jun 12, 2023 Accepting new patients

Locations

110 Andreas Dr NE
Sugarcreek, OH 44681
Phone (330) 852-2512

110 Andreas Dr NE
#A
Sugarcreek, OH 44681
Phone (330) 852-2512

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1568156602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6995 STATE ROUTE 241",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446549469",
            "telephone_number": "330-231-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ANDREAS DR NE",
            "city": "SUGARCREEK",
            "state": "OH",
            "postal_code": "446817503",
            "telephone_number": "330-852-2512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4606 Township Road 634",
            "address_purpose": "LOCATION",
            "city": "Millersburg",
            "state": "OH",
            "postal_code": "44660",
            "country_code": "US",
            "telephone_number": "330-231-0505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRANDT",
        "middle_name": "RILEY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "007158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugarcreek, OH

Sources for this page

Verify at the official NPI Registry.