Individual provider Active NPI

Raisa Miller, PA-C

  • Physician Assistant
  • Tavernier, FL
National Provider Identifier
1629045513
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9102221 Issued in FL
Practice address
91550 Overseas Hwy Ste 205
Tavernier, FL 33070-2513
Phone
(305) 434-3400
Fax
(786) 260-0513
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102221 FL
Physician Assistant 363A00000X PA9102221 FL Primary

Addresses

Primary practice location

91550 Overseas Hwy Ste 205
Tavernier, FL 33070-2513

Mailing address

PO Box 100707
Atlanta, GA 30384-0707
Phone (305) 434-3400

Other practice location 1

306 Lance Lane
Key Largo, FL 33037
Phone (305) 509-1108

Other practice location 2

5701 Overseas Hwy Ste 17
Marathon, FL 33050-2784
Phone (305) 852-9400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RAI15958@cerner.directbaptisthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20061115000153 FL Practitioner - Physician Assistant 8325046949 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

91550 Overseas Hwy
Tavernier, FL 33070-2513

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9102221FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Upper Keys, LLC CurrentSince Jul 17, 2023 Accepting new patients
Cleveland Clinic Florida a Nonprofit Corporation CurrentSince Jul 25, 2022 Accepting new patients
Baptist Health Medical Group Upper Keys, LLC CurrentSince Jul 17, 2023 Accepting new patients
Gastrocare LLP Past Accepting new patients
Machado Cardio Diagnostics Inc PastSince Mar 17, 2024 Accepting new patients

Locations

5701 Overseas Hwy
Ste 17
Marathon, FL 33050
Phone (305) 434-1400

91550 Overseas Hwy
Ste 205
Tavernier, FL 33070
Phone (305) 434-3400

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

Interoperability endpoints

  • Direct secure messaging: rai15958@cerner.directbaptisthealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1629045513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100707",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840707",
            "telephone_number": "305-434-3400",
            "fax_number": "786-260-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91550 OVERSEAS HWY STE 205",
            "city": "TAVERNIER",
            "state": "FL",
            "postal_code": "330702513",
            "telephone_number": "305-434-3400",
            "fax_number": "786-260-0513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 Lance Lane",
            "address_purpose": "LOCATION",
            "city": "Key Largo",
            "state": "FL",
            "postal_code": "33037",
            "country_code": "US",
            "telephone_number": "305-509-1108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5701 Overseas Hwy Ste 17",
            "address_purpose": "LOCATION",
            "city": "Marathon",
            "state": "FL",
            "postal_code": "330502784",
            "country_code": "US",
            "telephone_number": "305-852-9400",
            "fax_number": "305-852-6457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RAISA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102221",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RAI15958@cerner.directbaptisthealth.com",
            "affiliation": "N",
            "address_1": "306 Lance Lane",
            "city": "Key Largo",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tavernier, FL

Sources for this page

Verify at the official NPI Registry.