Individual provider Active NPI

Tiffany Miner, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1710283783
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1411 N Beckley Ave Ste 470
Dallas, TX 75203-1264
Phone
(214) 941-7546
Fax
(214) 941-2442
NPI assigned
Feb 8, 2011
Last updated
Jan 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

1411 N Beckley Ave Ste 470
Dallas, TX 75203-1264

Mailing address

1411 N Beckley Ave
Pavilion III, Suite 470
Dallas, TX 75203
Phone (214) 941-7546

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
I20120119000544 TX Practitioner - Physician Assistant 5890962617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniel D. Witheiler, M.D. P.a.Group PAC ID 0749346500, 2 clinicians

Practice addresses (Care Compare)

1411 N Beckley Ave
Pavilion III Suite 470
Dallas, TX 75203-1259

1411 N Beckley Ave
Pavilion III Suite 470
Dallas, TX 75203-1264
Phone (214) 941-7546

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edward E. Rotan, Jr., MD, P.a. Past Accepting new patients
Dermone Dermatology Associates of Texas PA Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1710283783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE",
            "address_2": "PAVILION III, SUITE 470",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75203",
            "telephone_number": "214-941-7546",
            "fax_number": "214-941-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE STE 470",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031264",
            "telephone_number": "214-941-7546",
            "fax_number": "214-941-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "TIFFANY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-08",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.