Individual provider Active NPI

Michael Miller, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Travis Afb, CA
National Provider Identifier
1609309475
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
20A20013 Issued in CA
Practice address
101 Bodin Cir
Travis Afb, CA 94535-1809
Phone
(707) 423-3216
NPI assigned
Apr 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0102205389 VA
General Practice Physician 208D00000X 0102205389 VA
Pain Medicine (Anesthesiology) Physician 207LP2900X 20A20013 CA Primary

Addresses

Primary practice location

101 Bodin Cir
Travis Afb, CA 94535-1809

Mailing address

101 Bodin Cir
Travis Afb, CA 94535-1809
Phone (707) 423-3216

Other practice location 1

2200 Bergquist Dr
WHMC/GE-2200 Ste 1
Jbsa Lackland, TX 78236-9907
Phone (210) 916-8666

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220914003831 CA Practitioner - Anesthesiology 4486039294 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Rocky Vista University College of Osteopathic Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

3901 Lone Tree Way
Antioch, CA 94509-6200
Phone (650) 845-7649

Hospital & facility affiliations

  • Sutter Delta Medical Center Hospital, Antioch, CA, CCN 050523

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A20013CAMDPain Medicine (Anesthesiology) Physician
0102205389VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Jul 12, 2023 Accepting new patients
Central Anesthesia Service Exchange Medical Group, Inc. Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients
Permanente Medical Group Inc Anesthesiology CurrentSince Jul 12, 2023 Accepting new patients
California Pain Specialists Inc CurrentSince Dec 1, 2022 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jul 31, 2023 Accepting new patients
Sacsolano Anesthesia Exchange Medical Group, Inc Anesthesiology CurrentSince Nov 7, 2024 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jul 31, 2023 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Permanente Medical Group Inc Anesthesiology Current Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations (25 of 36)

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

6939 Sunrise Blvd
Ste 106
Citrus Heights, CA 95610
Phone (916) 352-7777

7777 Greenback Ln
Ste 102
Citrus Hts, CA 95610
Phone (916) 352-7777

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

935 Trancas St
Ste 2C
Napa, CA 94558
Phone (707) 259-0766

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3315 Watt Ave
Sacramento, CA 95821
Phone (916) 481-0777

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

Interoperability endpoints

  • Direct secure messaging: mmiller633454@hisp.ehr.sutterhealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1609309475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Bergquist Dr",
            "address_2": "WHMC/GE-2200 Ste 1",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782369907",
            "country_code": "US",
            "telephone_number": "210-916-8666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-07",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0102205389",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102205389",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "20A20013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "975 Sereno Dr",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945892441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.