Individual provider Active NPI

Ellen Carol Miller, O.D.

  • Optometrist
  • Cedar Rapids, IA
National Provider Identifier
1710038245
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02055 Issued in IA
Practice address
576 Boyson Rd NE
Suite 104
Cedar Rapids, IA 52402-7363
Phone
(319) 373-3737
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02055 IA Primary

Addresses

Primary practice location

576 Boyson Rd NE
Suite 104
Cedar Rapids, IA 52402-7363

Mailing address

3330 Newcastle Rd
Marion, IA 52302-4784
Phone (319) 373-3737

Other identifiers 1

IdentifierTypeStateIssuer
3127506MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20110119000689 IA Practitioner - Optometry 3678752912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miller Family Eyecare, PLLCGroup PAC ID 3779762000, 4 clinicians

Practice addresses (Care Compare)

576 Boyson Rd NE
Suite 104
Cedar Rapids, IA 52402-7363
Phone (319) 373-3737

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02055IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Miller Family Eyecare, PLLC Optometrist CurrentSince Jan 1, 2011 Accepting new patients
Insight Vision Inc. Optometrist PastSince Jan 8, 2019 Accepting new patients

Locations

576 Boyson Rd NE
Ste 104
Cedar Rapids, IA 52402
Phone (319) 373-3737

Organizations & group practices 2

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1710038245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 NEWCASTLE RD",
            "city": "MARION",
            "state": "IA",
            "postal_code": "523024784",
            "telephone_number": "319-373-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 BOYSON RD NE",
            "address_2": "SUITE 104",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524027363",
            "telephone_number": "319-373-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ELLEN",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3127506",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.