Individual provider Active NPI

Michael Miller, O.D.

  • Optometrist
  • Portsmouth, OH
National Provider Identifier
1629482724
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.6300-THER Issued in OH
Practice address
1915 Scioto TRL
Portsmouth, OH 45662-2874
Phone
(740) 354-2821
Fax
(740) 354-6162
NPI assigned
Jun 17, 2014
Last updated
Jun 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.6300-THER OH Primary

Addresses

Primary practice location

1915 Scioto TRL
Portsmouth, OH 45662-2874

Mailing address

938 Rases Mountain Dr
Minford, OH 45653-8623
Phone (740) 981-6367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150114001126 OH Practitioner - Optometry 2567786833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portsmouth Vision Center, LTDGroup PAC ID 5698796068, 6 clinicians
Wheelersburg Vision Center LLCGroup PAC ID 9032537774, 3 clinicians

Practice addresses (Care Compare)

1915 Scioto TRL
Portsmouth, OH 45662-2874
Phone (740) 354-2821

536 Bulwer St
Wheelersburg, OH 45694-1907
Phone (740) 574-4745

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.6300-THEROHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wheelersburg Vision Center LLC Optometrist CurrentSince Jul 15, 2020 Accepting new patients
Portsmouth Vision Center, LTD Optometrist CurrentSince Dec 13, 2014 Accepting new patients
DRS Green & Brown Inc Optometrist PastSince Apr 29, 2002 Accepting new patients

Locations

1915 Scioto Trl
Portsmouth, OH 45662
Phone (740) 354-2821

536 Bulwer St
Wheelersburg, OH 45694
Phone (740) 574-1903

Organizations & group practices 3

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1629482724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 RASES MOUNTAIN DR",
            "city": "MINFORD",
            "state": "OH",
            "postal_code": "456538623",
            "telephone_number": "740-981-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 SCIOTO TRL",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622874",
            "telephone_number": "740-354-2821",
            "fax_number": "740-354-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.6300-THER",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.