Individual provider Active NPI

Hannah E Miller, PA-C

  • Physician Assistant
  • Green Bay, WI
National Provider Identifier
1710465604
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4478-23 Issued in WI
Practice address
2617 Development Dr
Green Bay, WI 54311-4240
Phone
(920) 336-8197
Fax
(920) 336-8801
NPI assigned
Aug 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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 4478-23 WI Primary

Addresses

Primary practice location

2617 Development Dr
Green Bay, WI 54311-4240

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

715 Superior Rd Ste 120
Green Bay, WI 54311-7595
Phone (920) 406-9803

Other practice location 2

3515 Murray St
Marinette, WI 54143-3367
Phone (715) 732-0699

Other practice location 3

N4531 State Highway 22 Ste 5
Shawano, WI 54166-6173
Phone (715) 524-5995

Other names 1

  • Hannah E Podvin Former name

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address Hannah.Miller@forefrontdermatology.emadirect.md
Direct Messaging Address Hannah.Miller@forefrontdermatology.emadirect.md
Direct Messaging Address Hannah.Miller@forefrontdermatology.emadirect.md
Direct Messaging Address Hannah.Miller@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20181018000377 WI Practitioner - Physician Assistant 1658623723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

1400 Scheuring Rd
De Pere, WI 54115-1067
Phone (920) 964-0229

2617 Development Dr
Green Bay, WI 54311-4240
Phone (920) 336-8197

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4478-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Current Accepting new patients
Forefront Dermatology, S.C. CurrentSince Nov 1, 2018 Accepting new patients
Forefront Dermatology, S.C. CurrentSince Nov 1, 2018 Accepting new patients
Forefront Dermatology, S.C. Past Accepting new patients

Locations

109 Warren St
Ste 1
Beaver Dam, WI 53916
Phone (920) 885-2622

700 Hillcrest Ct
Beaver Dam, WI 53916
Phone (920) 885-2622

1400 Scheuring Rd
De Pere, WI 54115
Phone (920) 964-0229

715 Superior Rd
Ste 120
Green Bay, WI 54311
Phone (920) 406-9803

2617 Development Dr
Green Bay, WI 54311
Phone (920) 336-8197

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

3515 Murray St
Marinette, WI 54143
Phone (715) 732-0699

Bin 88617
Milwaukee, WI 53288

N4531 State Highway 22
Ste 5
Shawano, WI 54166
Phone (715) 524-5995

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

2600 N Mayfair Rd
Ste 810
Wauwatosa, WI 53226
Phone (414) 771-1122

Interoperability endpoints

  • Direct secure messaging: hannah.miller@forefrontdermatology.emadirect.md

Organizations & group practices 5

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": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1710465604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 DEVELOPMENT DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114240",
            "telephone_number": "920-336-8197",
            "fax_number": "920-336-8801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Superior Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543117595",
            "country_code": "US",
            "telephone_number": "920-406-9803",
            "fax_number": "920-406-9934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3515 Murray St",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433367",
            "country_code": "US",
            "telephone_number": "715-732-0699",
            "fax_number": "715-732-3522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N4531 State Highway 22 Ste 5",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541666173",
            "country_code": "US",
            "telephone_number": "715-524-5995",
            "fax_number": "715-953-4257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "HANNAH",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4478-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Hannah.Miller@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "715 Superior Rd Ste 120",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543117595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Hannah.Miller@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2617 Development Dr",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543114240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Hannah.Miller@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "N4531 State Highway 22 Ste 5",
            "city": "Shawano",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541666173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Hannah.Miller@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "3515 Murray St",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541433367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "PODVIN",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.