Jacob A Miller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3120 Issued in NE

Practice address

16901 Lakeside Hills CT
Omaha, NE 68130-2318

Phone

(402) 398-6161

Fax

(402) 398-6982

NPI assigned

May 16, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

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 and National Provider Directory roles.

• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment NPD
• Midwest Emergency Grand Island Inc

  • Emergency Medicine Physician
  • Grand Island, NE
  • NPI 1508357930
  Medicare reassignment
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1154680700
  NPD

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1588413074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16901 LAKESIDE HILLS CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302318",
            "telephone_number": "402-398-6161",
            "fax_number": "402-398-6982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2620 W Faidley Ave",
            "address_purpose": "LOCATION",
            "city": "Grand Island",
            "state": "NE",
            "postal_code": "688034205",
            "country_code": "US",
            "telephone_number": "308-384-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACOB",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-16",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "3120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Ann Miller
• Gary H Miller, DDS
• Georgia Miller
• Hailey Nicole Miller
• Hilaire Miller
• Jacqueline E Miller, MS, LMHP
• Jamie Miller
• Jason Jay Miller, MD
• Jaycee Shae Miller
• Jenelle Miller, MS, LIMHP, ATR

• Physician Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Physician Assistant in Nebraska

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

Verify at the official NPI Registry.