Active NPI
Timothy Isaac Miller
- Clinical Pathology/Laboratory Medicine Physician
- Fargo, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- 22190
- Practice address
- 4840 23Rd Ave S
Fargo, ND 58104-9136 - Phone
- (701) 417-6999
- NPI assigned
- Mar 29, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MDRE.ML.60952186 | WA | |
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 22190 | ND | Primary |
Addresses
Primary practice location
4840 23Rd Ave S
Fargo, ND 58104-9136
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | timiller@uw.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDRE.ML.60952186 | WA | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients |
Locations
4840 23rd Ave S
Fargo, ND 58104
Phone (701) 234-4445
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
-
dba Sanford Ellendale Clinic
- Rural Health Clinic/Center
- Ellendale, ND
- NPI 1346256682
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
Hospital
-
dba Sanford Physical Therapy
- General Acute Care Hospital
- Fargo, ND
- NPI 1245519081
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
dba Sanford Bemidji
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754438400000",
"number": "1568923605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074",
"telephone_number": "605-328-9419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4840 23RD AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581049136",
"telephone_number": "701-417-6999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "TIMOTHY",
"middle_name": "ISAAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-29",
"last_updated": "2025-08-06",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "WA",
"license": "MDRE.ML.60952186",
"primary": false
},
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "ND",
"license": "22190",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "timiller@uw.edu",
"affiliation": "N",
"address_1": "1959 NE Pacific St",
"city": "Seattle",
"state": "WA",
"country_code": "US",
"postal_code": "981950001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.