Individual provider Active NPI

Tracey Miller, PA

  • Medical Physician Assistant
  • Sugar Land, TX
National Provider Identifier
1710063409
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00285 Issued in TX
Practice address
16659 Southwest Fwy # 461
Sugar Land, TX 77479-2375
Phone
(281) 340-9355
Fax
(281) 340-9366
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00285 TX Primary

Addresses

Primary practice location

16659 Southwest Fwy # 461
Sugar Land, TX 77479-2375

Mailing address

16659 Southwest Fwy # 461
Sugar Land, TX 77479-2375
Phone (281) 340-9355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070226000646 TX Practitioner - Physician Assistant 5395847123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

Hospital & facility affiliations

  • Houston Methodist Sugarland Hospital Hospital, Sugar Land, TX, CCN 450820
  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • Memorial Hermann Sugar Land Hospital Hospital, Sugar Land, TX, CCN 450848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast PLLC CurrentSince Jun 18, 2017 Accepting new patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Jun 18, 2017 Accepting new patients

Locations

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

1200 Binz St
Ste 1490
Houston, TX 77004
Phone (713) 512-7027

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

16659 Southwest Fwy
Ste 461
Sugar Land, TX 77479
Phone (281) 340-9355

1111 Highway 6
Ste 40
Sugar Land, TX 77478
Phone (281) 340-9355

Interoperability endpoints

  • Direct secure messaging: tracey.miller.1@8042.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710063409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16659 SOUTHWEST FWY # 461",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792375",
            "telephone_number": "281-340-9355",
            "fax_number": "281-340-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16659 SOUTHWEST FWY # 461",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792375",
            "telephone_number": "281-340-9355",
            "fax_number": "281-340-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TRACEY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.