NPIMap

Individual provider Active NPI

Mariam Imnadze Miller, M.D.

  • Urology Physician
  • Anchorage, AK
National Provider Identifier
1659533222
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
101249 Issued in AK
Practice address
4315 Diplomacy Dr
Dept of Urology
Anchorage, AK 99508-5926
Phone
(855) 482-4382
NPI assigned
Jun 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 101249 AK Primary

Addresses

Primary practice location

4315 Diplomacy Dr
Dept of Urology
Anchorage, AK 99508-5926

Mailing address

4315 Diplomacy Drive
Dept of Urology
Anchorage, AK 99508
Phone (907) 729-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151024000191 TX Practitioner - Urology 3870713605 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
State University of New York at Buffalo School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Alaska Regional Health ConsortiumGroup PAC ID 1456265362, 373 clinicians
Alaska Native Tribal Health ConsortiumGroup PAC ID 6709780265, 605 clinicians

Practice addresses (Care Compare)

1204 Seward Ave
Searhc 1204 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1206 Seward Ave
Searhc 1206 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1209 Seward Ave
Searhc 1209 Behavioral
Sitka, AK 99835-7359
Phone (907) 966-8611

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

227 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

3900 Ambassador Dr
Anchorage, AK 99508-5922
Phone (907) 563-2662

3976 University Lake Dr
Suite 100
Anchorage, AK 99508-4644
Phone (907) 563-2662

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone (907) 265-4955

Hospital & facility affiliations

  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026
  • Southeast Alaska Regional Health Consortium Hospital, Sitka, AK, CCN 021314

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation CurrentSince Nov 3, 2015 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 30, 2017 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 30, 2017 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Sep 8, 2015 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Nov 3, 2015 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

Interoperability endpoints

  • Direct secure messaging: mimiller@direct.anthc.org

Organizations & group practices 7

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 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1659533222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DRIVE",
            "address_2": "DEPT OF UROLOGY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-729-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "address_2": "DEPT OF UROLOGY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926",
            "telephone_number": "855-482-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARIAM",
        "middle_name": "IMNADZE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AK",
            "license": "101249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.