Individual provider Active NPI

Adam David Miller, MD

  • Dermatology Physician
  • Waukee, IA
National Provider Identifier
1578068367
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD-51875 Issued in IA
Practice address
830 NE Alices Rd
Waukee, IA 50263-8857
Phone
(515) 875-9766
Fax
(515) 875-9611
NPI assigned
Mar 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD-51875 IA Primary

Addresses

Primary practice location

830 NE Alices Rd
Waukee, IA 50263-8857

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9925

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adammiller@tic.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20230927001788 IA Practitioner - DermatologyPractitioner - Other (Physician) 4183008451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Iowa, RJ & L Carver College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PC 307 clinicians

Practice addresses (Care Compare)

830 NE Alices Rd
Waukee, IA 50263-8857
Phone (515) 875-9100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision239
Removal of skin lesions164
Removal of skin cancer649
Removal or shaving of skin growth1-10
Skin biopsy44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic, PC CurrentSince Oct 23, 2023 Accepting new patients
The Iowa Clinic PC CurrentSince Oct 23, 2023 Accepting new patients

Locations

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

830 NE Alices Rd
Waukee, IA 50263
Phone (515) 875-9610

Interoperability endpoints

  • Direct secure messaging: adammiller@tic.allscriptsdirect.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1578068367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9925",
            "fax_number": "515-875-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 NE ALICES RD",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502638857",
            "telephone_number": "515-875-9766",
            "fax_number": "515-875-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ADAM",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "MD-51875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adammiller@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "830 NE Alices Rd",
            "city": "Waukee",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502638857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waukee, IA

Sources for this page

Verify at the official NPI Registry.