Individual provider Active NPI

Megan E Milloy, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1619174422
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1130 Issued in NV
Practice address
2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone
(702) 243-8525
Fax
(702) 636-8753
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1130 NV Primary

Addresses

Primary practice location

2704 N Tenaya Way
Las Vegas, NV 89128-0424

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 560-2900

Other identifiers 1

IdentifierTypeStateIssuer
1619174422MedicaidNV

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20070910000332 WI Practitioner - Physician Assistant 9436242351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hand to Shoulder Center of Wisconsin, LTD.Group PAC ID 6901884337, 34 clinicians

Practice addresses (Care Compare)

2323 N Casaloma Dr
Appleton, WI 54913-8284
Phone (920) 730-8833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1130NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hand to Shoulder Center of Wisconsin, LTD. CurrentSince Sep 1, 2018 Accepting new patients
Woodland Surgery Center LLC Current Accepting new patients
Linda L. Johnson MD, LTD Past Accepting new patients
Dr. Terry D. Johnson, P.a. Past Accepting new patients

Locations

2323 N Casaloma Dr
Appleton, WI 54913

1551 Park Pl
Ste 100
Green Bay, WI 54304

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1619174422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-560-2900",
            "fax_number": "702-560-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280424",
            "telephone_number": "702-243-8525",
            "fax_number": "702-636-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLOY",
        "first_name": "MEGAN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619174422",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.