Individual provider Active NPI

Mark Douglas Miller, O.D.

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1821167404
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
279 Issued in NV
Practice address
6230 N Durango Dr
Las Vegas, NV 89149-3916
Phone
(702) 737-3937
Fax
(702) 737-8860
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 279 NV Primary

Addresses

Primary practice location

6230 N Durango Dr
Las Vegas, NV 89149-3916

Mailing address

6230 N Durango Dr
Las Vegas, NV 89149-3916
Phone (702) 737-3937

Other identifiers 1

IdentifierTypeStateIssuer
002502000MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040628000596 NV Practitioner - Optometry 7810973120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miller and Miller OD LTDGroup PAC ID 5991781619, 3 clinicians

Practice addresses (Care Compare)

6230 N Durango Dr
Las Vegas, NV 89419
Phone (702) 737-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Miller and Miller, OD LTD Optometrist CurrentSince Mar 11, 2004 Accepting new patients

Locations

6230 N Durango Dr
Las Vegas, NV 89149
Phone (702) 737-3937

Organizations & group practices 1

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1821167404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 N DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891493916",
            "telephone_number": "702-737-3937",
            "fax_number": "702-737-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 N DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891493916",
            "telephone_number": "702-737-3937",
            "fax_number": "702-737-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARK",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002502000",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.