Individual provider Active NPI

Frederick Eugene Miller, MD

  • Psychiatry Physician
  • Evanston, IL
National Provider Identifier
1780604041
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036069862 Issued in IL
Practice address
2650 Ridge Ave
Department of Psychiatry
Evanston, IL 60201-1718
Phone
(847) 570-2540
Fax
(847) 570-2939
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036069862 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Department of Psychiatry
Evanston, IL 60201-1718

Mailing address

2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201-1718
Phone (847) 570-1206

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fmiller7791@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20050901000070 IL Practitioner - Psychiatry 0345212858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Chicago, Pritzker School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Current Accepting new patients
Endeavor Health Medical Group CurrentSince May 5, 1997 Accepting new patients
Glenbrook Hospital Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Rm 1223
Evanston, IL 60201
Phone (847) 570-1644

Interoperability endpoints

  • Direct secure messaging: fmiller7791@direct.northshore.org

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 and National Provider Directory roles.

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1780604041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "EVANSTON HOSPITAL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1206",
            "fax_number": "847-570-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2540",
            "fax_number": "847-570-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "FREDERICK",
        "middle_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036069862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fmiller7791@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2650 Ridge Ave",
            "address_2": "Department of Psychiatry",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602011718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.