Shane A Milliron, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6203 Issued in AZ

Practice address

1244 N Greenfield Rd
Mesa, AZ 85205-4077

Phone

(480) 964-6900

Fax

(480) 964-6901

NPI assigned

Oct 28, 2015

Last updated

Jan 22, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Greenfield Family Medicine LLC

  • Medical Physician Assistant
  • Mesa, AZ
  • NPI 1336255264
  Medicare reassignment
• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1568834729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 N GREENFIELD RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054077",
            "telephone_number": "480-964-6900",
            "fax_number": "480-964-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 N GREENFIELD RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054077",
            "telephone_number": "480-964-6900",
            "fax_number": "480-964-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIRON",
        "first_name": "SHANE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-28",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Ashley Miller, OTR/L
• Starla Lucille Miller, RN
• Steven Gregory Miller, DMT
• Steven H. Miller, MD
• Zachary William Miller, OD
• Amanda Mills, PT
• Antonia Mills
• Brooke Naomi Mills
• Destiny Mills
• Joyce A Mills, MPT

• Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.