Miles Burton Andrew, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01040450A Issued in IN

Practice address

230 E Day Rd
Suite 130
Mishawaka, IN 46545-3408

Phone

(574) 335-7650

Fax

(574) 335-0736

NPI assigned

Jul 17, 2006

Last updated

Sep 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

DermatologyAlso: Family Practice

Education

University of Wisconsin School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/
• Direct secure messaging: mandrew252496@dulyhealthandcare.direct-ci.com

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.

• The South Bend Clinic LLC

  • Clinic/Center
  • South Bend, IN
  • NPI 1073680419
  Medicare reassignment Care Compare group NPD
• Applegarth Dermatology PC

  • Specialist
  • Valparaiso, IN
  • NPI 1619010626
  Medicare reassignment NPD
• The South Bend Clinic, LLC

  • Anesthesiology Physician
  • South Bend, IN
  • NPI 1487307492
  NPD
• Applegarth Dermatology PC

  • Medical Physician Assistant
  • Valparaiso, IN
  • NPI 1982096822
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1689692188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E CEDAR ST",
            "address_2": "STE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172057",
            "telephone_number": "574-335-8700",
            "fax_number": "574-335-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E DAY RD",
            "address_2": "SUITE 130",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453408",
            "telephone_number": "574-335-7650",
            "fax_number": "574-335-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREW",
        "first_name": "MILES",
        "middle_name": "BURTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01040450A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Anderson, RBT
• Andrew R Anderson, OD
• Jane Elizabeth Anderson, PT
• Kiesha Anderson, D.O.
• Jessica Andreen
• Gregory Andrianov, MD
• Hari Priya Anne, DDS
• Christy Lynn Annis, M.D.
• Bilal Ansari, M.D.
• Muhammad Shahzad Mumtaz Ansari, M.D.

• Dermatology Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.