Active NPI
David Paul Miller, MD
- Pediatrics Physician
- Edina, MN
National Provider Identifier
1851404644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 43544
- Practice address
- 3955 Parklawn Ave
Ste 120
Edina, MN 55435-5655 - Phone
- (952) 831-1944
- Fax
- (952) 278-6947
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 43544 | MN | Primary |
Addresses
Primary practice location
3955 Parklawn Ave
Ste 120
Edina, MN 55435-5655
Mailing address
3955 Parklawn Ave
Ste 120
Edina, MN 55435-5655
Phone (952) 831-1944
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1201254 | Other | MN | MEDICA |
| 026J2MI | Other | MN | BC/BS |
| FP9021027259 | Other | MN | PREFERRED ONE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091209000509 | MN | Practitioner - Pediatric Medicine | 1658410311 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southdale Pediatric Associates, LTD | Current | Accepting new patients |
Locations
501 E Nicollet Blvd
Ste 200
Burnsville, MN 55337
Phone (952) 278-7000
11095 Viking Dr
Ste 250
Eden Prairie, MN 55344
Phone (952) 278-7000
3955 Parklawn Ave
Ste 120
Minneapolis, MN 55435
Phone (952) 278-7000
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/1846cf9e-8006-4277-b72f-3cbbe8a8f5ca/
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": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851404644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3955 PARKLAWN AVE",
"address_2": "STE 120",
"city": "EDINA",
"state": "MN",
"postal_code": "554355655",
"telephone_number": "952-831-1944",
"fax_number": "952-278-6947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3955 PARKLAWN AVE",
"address_2": "STE 120",
"city": "EDINA",
"state": "MN",
"postal_code": "554355655",
"telephone_number": "952-831-1944",
"fax_number": "952-278-6947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DAVID",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "43544",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1201254",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "026J2MI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "FP9021027259",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.