Nicole L Miller, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005276 Issued in MI

Practice address

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Phone

(313) 593-8780

Fax

(313) 436-2864

NPI assigned

May 22, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicole L Fretter Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Observation Medicine Group PLLCGroup PAC ID 6305001777, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmiller1141644@direct.hfhs.org

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.

• Observation Medicine Group PLLC

  • Emergency Medicine Physician
  • Grand Blanc, MI
  • NPI 1194084111
  Medicare reassignment Care Compare group
• Michigan Orthopaedic Surgeons, PLLC

  • Orthopaedic Surgery Physician
  • Southfield, MI
  • NPI 1306394309
  Medicare reassignment NPD
• Emergency Medicine Physicians of Genesee County, PLLC

  • Emergency Medicine Physician
  • Grand Blanc, MI
  • NPI 1275899171
  Medicare reassignment
• Emergency Professionals of Michigan, P.C.

  • Emergency Medicine Physician
  • Dearborn, MI
  • NPI 1952740656
  Medicare reassignment
• Ihp Mi Emergency Medicine PLLC

  • Emergency Medicine Physician
  • Garden City, MI
  • NPI 1861147456
  Medicare reassignment

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

• Henry Ford Health Genesys Hospital

  • General Acute Care Hospital
  • Grand Blanc, MI
  • NPI 1407877723
  Care Compare affiliation

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1801053285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503397",
            "telephone_number": "734-632-0175",
            "fax_number": "866-250-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-8780",
            "fax_number": "313-436-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11994868",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "FRETTER",
            "middle_name": "L",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Patrick Miller, PT, DPT
• Jorja N Miller
• Kaitlyn C Miller
• Lindsay Miller
• Natasha Helena Miller, LMSW
• Paris Marie Miller, PH.D.
• Robert A Miller, DDS MS
• Sabrina Miller
• Sophie Anne Miller
• James Tony Millican Jr., M.D.

• Physician Assistant in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.