Individual provider Active NPI

Kevin Michael Miller, D.O.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1871855775
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS018019 Issued in PA
Practice address
5501 Old York Rd
Albert Einstein Medical Center
Philadelphia, PA 19141
Phone
(215) 456-3834
NPI assigned
Jun 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT014843 PA
Emergency Medicine Physician 207P00000X OS018019 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Albert Einstein Medical Center
Philadelphia, PA 19141

Mailing address

5501 Old York Rd
Albert Einstein Medical Center
Philadelphia, PA 19141-3018
Phone (215) 456-4695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160614000313 PA Practitioner - Emergency Medicine 9638460157 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS018019PAMDEmergency Medicine Physician
OT014843PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Oct 29, 2016 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
Doylestown Emergency Associates PC Emergency Medicine CurrentSince May 2, 2017 Accepting new patients
Einstein Practice Plan, Inc CurrentSince Oct 29, 2016 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
St. Luke's Physician Group, Inc CurrentSince Jul 1, 2020 Accepting new patients
St Luke's Physician Group Inc CurrentSince Jul 1, 2020 Accepting new patients
Doylestown Emergency Associates PC Past Accepting new patients

Locations

595 W State St
Doylestown, PA 18901
Phone (215) 345-2200

250 S 21st St
Easton, PA 18042
Phone (610) 250-4300

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

700 Lawn Ave
Sellersville, PA 18960
Phone (215) 453-4000

Interoperability endpoints

  • Direct secure messaging: kevin.miller@slpg.direct-sluhn.org

Organizations & group practices 8

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1871855775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "ALBERT EINSTEIN MEDICAL CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "ALBERT EINSTEIN MEDICAL CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19141",
            "telephone_number": "215-456-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT014843",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS018019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.