Individual provider Active NPI

Robert Bruce Miller, MD

  • Physical Medicine & Rehabilitation Physician
  • Fremont, CA
National Provider Identifier
1841293271
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A76380 Issued in CA
Practice address
4535 Mattos Drive
Fremont, CA 94536-6719
Phone
(510) 795-7746
Fax
(510) 795-7710
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A76380 CA Primary

Addresses

Primary practice location

4535 Mattos Drive
Fremont, CA 94536-6719

Mailing address

PO Box 8310
Fremont, CA 94537-8310
Phone (510) 795-7746

Other identifiers 1

IdentifierTypeStateIssuer
00A76380MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20101118001289 CA Practitioner - Physical Medicine and Rehabilitation 1759327091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Cincinnati College of Medicine and Surgery, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4535 Mattos Dr
Fremont, CA 94536-6736
Phone (501) 795-7746

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Bruce Miller, M.D.,Inc. Physical Medicine & Rehabilitation CurrentSince Aug 29, 2001 Accepting new patients
Washington Township Hospital District Past Accepting new patients

Locations

4535 Mattos Dr
Fremont, CA 94536
Phone (501) 795-7746

Interoperability endpoints

  • Direct secure messaging: robert.miller@26073918930948.direct.elationemr.com

Organizations & group practices 2

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1841293271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8310",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945378310",
            "telephone_number": "510-795-7746",
            "fax_number": "510-795-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 MATTOS DRIVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366719",
            "telephone_number": "510-795-7746",
            "fax_number": "510-795-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROBERT",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A76380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A76380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.