Individual provider Active NPI

Geoffrey Miller, PT, DPT

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1598174377
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11057 Issued in AZ
Practice address
6795 W Amigo Dr
Glendale, AZ 85308-8921
Phone
(570) 640-1190
Fax
(000) 000-0000
NPI assigned
Aug 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11057 AZ Primary

Addresses

Primary practice location

6795 W Amigo Dr
Glendale, AZ 85308-8921

Mailing address

17100 N 67TH Ave
Building 100
Glendale, AZ 85308-3605
Phone (623) 979-2747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141120000146 AZ Practitioner - Physical Therapist in Private Practice 9335361724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capptcg, LLCGroup PAC ID 2668770157, 30 clinicians

Practice addresses (Care Compare)

1255 N Arizona Ave
Unit 1217
Chandler, AZ 85225-0710
Phone (602) 380-6807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11057AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Wound Solutions, LLC CurrentSince Jan 15, 2025 Accepting new patients

Locations

10210 N 92nd St
Ste 104
Scottsdale, AZ 85258
Phone (480) 493-0900

Organizations & group practices 2

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": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1598174377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 N 67TH AVE",
            "address_2": "BUILDING 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083605",
            "telephone_number": "623-979-2747",
            "fax_number": "623-979-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6795 W AMIGO DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088921",
            "telephone_number": "570-640-1190",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GEOFFREY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.