NPIMap

Individual provider Active NPI

Jeffrey S. Miller, D.O.

  • Family Medicine Physician
  • St Louis Park, MN
National Provider Identifier
1801897061
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
56241 Issued in WI
Practice address
3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone
(952) 993-3400
NPI assigned
Aug 9, 2005
Last updated
Jun 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 56241 WI Primary

Addresses

Primary practice location

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Mailing address

PO Box 1309
8170 33Rd Ave S Mail Stop 21110Q
Minneapolis, MN 55425-4516
Phone (651) 439-1234

Other practice location 1

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040
Phone (651) 439-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160412001114 MN Practitioner - Family Practice 6305960568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amery Regional Medical Center IncGroup PAC ID 2769391960, shared by 7 NPIs, 124 clinicians
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

265 Griffin E St
Amery, WI 54001-1439
Phone (715) 268-8000

265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6000 Earle Brown Dr
Brooklyn Center, MN 55430-2506
Phone (952) 993-4900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56241WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine CurrentSince Jul 29, 2019 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Jul 29, 2019 Accepting new patients
Crawford County Memorial Hospital Family Medicine Past Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

3850 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 883-1000

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 7

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1801897061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "address_2": "8170 33RD AVE S MAIL STOP 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-439-1234",
            "fax_number": "651-275-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Curve Crest Blvd W",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550826040",
            "country_code": "US",
            "telephone_number": "651-439-1234",
            "fax_number": "651-275-3325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JEFFREY",
        "middle_name": "S.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "56241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.