Individual provider Active NPI

Matthew Lloyd Miller, MD

  • Dermatology Physician
  • Greenville, SC
National Provider Identifier
1679528756
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
21984 Issued in SC
Practice address
369 Woodruff Rd
Greenville, SC 29607-3415
Phone
(864) 242-5872
Fax
(864) 242-5640
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 21984 SC Primary

Addresses

Primary practice location

369 Woodruff Rd
Greenville, SC 29607-3415

Mailing address

PO Box 17527
Greenville, SC 29606-8527
Phone (864) 242-5872

Other identifiers 1

IdentifierTypeStateIssuer
219846MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041006000930 SC Practitioner - Dermatology 4183536428 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
West Virginia University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Fix SC LLCGroup PAC ID 2163819137, 3 clinicians
Advanced Dermatology of SC PCGroup PAC ID 4284864372, 32 clinicians

Practice addresses (Care Compare)

1520 Two Notch Rd SE
Aiken, SC 29803-5551
Phone (803) 649-3909

26 Roper Corners Cir
Greenville, SC 29615-4833
Phone (864) 234-7744

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision110
Removal of tissue1-10
Removal of skin lesions3008
Removal or shaving of skin growth145
Skin biopsy762

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21984SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Current Accepting new patients
Advanced Dermatology of SC PC Dermatology CurrentSince Dec 3, 2021 Accepting new patients
Prisma Health University Medical Group CurrentSince Jun 5, 2013 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

369 Woodruff Rd
Greenville, SC 29607
Phone (864) 242-5872

26 Roper Corners Cir
Greenville, SC 29615
Phone (864) 234-7744

1650 Skylyn Dr
Ste 402
Spartanburg, SC 29307
Phone (864) 574-0017

Organizations & group practices 4

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1679528756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17527",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296068527",
            "telephone_number": "864-242-5872",
            "fax_number": "864-242-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 WOODRUFF RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073415",
            "telephone_number": "864-242-5872",
            "fax_number": "864-242-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MATTHEW",
        "middle_name": "LLOYD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "21984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219846",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.