Individual provider Active NPI

Rutha Mae Miller

  • Physician Assistant
  • Van Nuys, CA
National Provider Identifier
1851006431
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
14614 Victory Blvd
Van Nuys, CA 91411-1621
Phone
(747) 264-1212
NPI assigned
Jan 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

14614 Victory Blvd
Van Nuys, CA 91411-1621

Mailing address

14614 Victory Blvd
Van Nuys, CA 91411-1621

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250509001958 CA Practitioner - Physician Assistant 6406373711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ae Urgent Care - Van NuysGroup PAC ID 0749651750, 5 clinicians
Daniel Ghiyam MD IncGroup PAC ID 1850429085, 4 clinicians

Practice addresses (Care Compare)

14614 Victory Blvd
Van Nuys, CA 91411-1621
Phone (747) 264-1212

2840 E Los Angeles Ave
Simi Valley, CA 93065-3937
Phone (805) 526-8360

Hospital & facility affiliations

  • Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64177CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ae Urgent Care - Van Nuys CurrentSince May 2, 2026 Accepting new patients

Locations

14614 Victory Blvd
Van Nuys, CA 91411
Phone (747) 262-0568

Interoperability endpoints

  • Direct secure messaging: rutha.miller.p9@direct.regal.nextgenshare.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.

Hospital & facility affiliations 1

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": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1851006431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14614 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14614 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111621",
            "telephone_number": "747-264-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RUTHA",
        "middle_name": "MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.