David T Miyama, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

33184 Issued in WI

Practice address

2350 N Lake Dr
Suite 406
Milwaukee, WI 53211-4528

Phone

(414) 271-4141

Fax

(414) 271-4343

NPI assigned

Nov 9, 2005

Last updated

Mar 18, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Otolaryngology

Education

University of Michigan Medical School, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Columbia St. Mary's Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Columbia St. Mary's Hospital Milwaukee Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1225071491
  NPD
• Columbia St. Mary's Hospital Milwaukee Inc

  dba Ascension Columbia St Mary's Hospital Ozaukee

  • Psychiatric Hospital Unit
  • Mequon, WI
  • NPI 1417600909
  NPD
• ENT Clinic P.C.

  dba Michigan Institute for Ear, Nose & Throat Health

  • Otolaryngology Physician
  • Bay City, MI
  • NPI 1285625020
  NPD
• Valley ENT, PC

  • Otolaryngology Physician
  • Scottsdale, AZ
  • NPI 1508990185
  NPD (past)
• Valley ENT, PC

  • Otolaryngology Physician
  • Tucson, AZ
  • NPI 1770852600
  NPD (past)

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

• Columbia St. Mary's Hospital Milwaukee, Inc.

  dba Ascension Columbia St Mary's Hospital Milwaukee Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1871656082
  Care Compare affiliation

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1568443240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-326-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N LAKE DR",
            "address_2": "SUITE 406",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-271-4141",
            "fax_number": "414-271-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYAMA",
        "first_name": "DAVID",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301051920",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "33184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "0090129",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4172040",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HELATHPLUS PROVIDER ID",
            "identifier": "0400661",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Mitten, RN, BSN
• Mixe Transport Service LLC
• Mixlab Wi, LLC
• Ashleigh Mixon
• Roger C Mixter, M.D.
• Amanda Taylor Mizia, PA-C
• MJ Care, Inc.
• Mjay Supportive Care Agency LLC
• MJB Transportation LLC
• Mjcare, Inc.

• Otolaryngology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Otolaryngology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.