Individual provider Active NPI

Madison Miller, OT

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
National Provider Identifier
1619716347
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
OTH009609 Issued in AZ
Practice address
1190 E Missouri Ave Ste 100
Phoenix, AZ 85014-2719
Phone
(602) 393-0520
NPI assigned
May 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Physical Medicine & Rehabilitation Physician 208100000X OTH009609 AZ Primary

Addresses

Primary practice location

1190 E Missouri Ave Ste 100
Phoenix, AZ 85014-2719

Mailing address

777 E Stella LN Apt 241
Phoenix, AZ 85014-0010
Phone (765) 650-1066

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240620002723 AZ Practitioner - Occupational Therapist in Private Practice 5294278024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RWW Outpatient Rehab Services, LLCGroup PAC ID 8729333521, 108 clinicians

Practice addresses (Care Compare)

1190 E Missouri Ave
Suite 100
Phoenix, AZ 85014-2719
Phone (602) 393-0520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTH009609AZMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RWW Outpatient Rehab Services, LLC Occupational Therapist CurrentSince May 17, 2024 Accepting new patients

Locations

13481 W McDowell Rd
Ste 300
Goodyear, AZ 85395
Phone (623) 536-2325

1190 E Missouri Ave
Ste 100
Phoenix, AZ 85014
Phone (602) 393-0520

Organizations & group practices 1

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": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1619716347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E STELLA LN APT 241",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850140010",
            "telephone_number": "765-650-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 E MISSOURI AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142719",
            "telephone_number": "602-393-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MADISON",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "OTH009609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.