Individual provider Active NPI

Dustin Joseph Miller, NP-C

  • Family Nurse Practitioner
  • Port Barre, LA
National Provider Identifier
1790235000
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP09016 Issued in LA
Practice address
414 Saizon St
Port Barre, LA 70577
Phone
(337) 447-4027
Fax
(337) 585-2674
NPI assigned
Oct 11, 2016
Last updated
Oct 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP09016 LA Primary

Addresses

Primary practice location

414 Saizon St
Port Barre, LA 70577

Mailing address

1119 Prudhomme Cir Ste F
Opelousas, LA 70570-6516
Phone (337) 942-5899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20161219000534 LA Practitioner - Nurse Practitioner 5799065371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acadiana Practitioners LLCGroup PAC ID 4587924188, 16 clinicians

Practice addresses (Care Compare)

1119 Prudhomme Cir
Suite F
Opelousas, LA 70570-6516
Phone (337) 447-4027

166 Oak Tree Park Dr
Suite B
Sunset, LA 70584-6135
Phone (337) 447-4027

414 Saizan Ave
Port Barre, LA 70577-5156
Phone (337) 447-4027

414 Saizon St
Port Barre, LA 70577-5156

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acadiana Practitioners LLC CurrentSince Feb 5, 2018 Accepting new patients
Acadiana Practitioners LLC CurrentSince Jan 20, 2017 Accepting new patients
Acadiana Practitioners LLC Family Past Accepting new patients
Acadiana Practitioners LLC Nurse Practitioner PastSince Jul 5, 2020 Accepting new patients

Locations

1119 Prudhomme Cir
Ste F
Opelousas, LA 70570
Phone (337) 942-5899

611 E Prudhomme St
Ste 5
Opelousas, LA 70570
Phone (337) 942-5899

414 Saizan Ave
Port Barre, LA 70577
Phone (337) 447-4027

166 Oak Tree Park Dr
#B
Sunset, LA 70584
Phone (337) 447-4027

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Acadiana Practitioners LLCPort Barre, LA, CCN 193936 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
General Partnership Interest (50%)
Corporate Officer (50%)
Operational/Managerial Control (50%)
Sep 6, 2017
Sep 6, 2017
Sep 6, 2017
Sep 6, 2017
Acadiana Practitioners OpelousasOpelousas, LA, CCN 193945 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
General Partnership Interest (50%)
Corporate Officer (50%)
Operational/Managerial Control (50%)
Sep 6, 2017
Sep 6, 2017
Sep 6, 2017
Sep 6, 2017
Acadiana Practitioners SunsetSunset, LA, CCN 193972 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
General Partnership Interest (50%)
Corporate Officer (50%)
Operational/Managerial Control (50%)
Sep 6, 2017
Sep 6, 2017
Sep 6, 2017
Sep 6, 2017
Acadiana Practitioners' Gastro ClinicOpelousas, LA, CCN 198932 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
General Partnership Interest (50%)
Corporate Officer (50%)
Operational/Managerial Control (50%)
Sep 6, 2017
Sep 6, 2017
Sep 6, 2017
Sep 6, 2017
Acadiana Practitioners' Specialty ClinicOpelousas, LA, CCN 198933 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer (50%)
Operational/Managerial Control (50%)
Sep 6, 2017
Sep 6, 2017
Sep 6, 2017

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 2

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": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1790235000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 PRUDHOMME CIR STE F",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705706516",
            "telephone_number": "337-942-5899",
            "fax_number": "337-585-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 SAIZON ST",
            "city": "PORT BARRE",
            "state": "LA",
            "postal_code": "70577",
            "telephone_number": "337-447-4027",
            "fax_number": "337-585-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DUSTIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-11",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Barre, LA

Sources for this page

Verify at the official NPI Registry.