Individual provider Active NPI

Grace Miller

  • Surgical Physician Assistant
  • Berea, OH
National Provider Identifier
1891456877
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
275 Eastland Rd
Berea, OH 44017-2005
Phone
(440) 826-8012
NPI assigned
Jan 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

275 Eastland Rd
Berea, OH 44017-2005

Mailing address

275 Eastland Rd
Berea, OH 44017-2005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230822001726 IN Practitioner - Physician Assistant 4880056969 Reassigns benefits to 1 organization
I20230830001613 OH Practitioner - Physician Assistant 4880056969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Dermatology Center PCGroup PAC ID 5496706210, 12 clinicians

Practice addresses (Care Compare)

1185 Wayne Ave
Greenville, OH 45331-1171
Phone 7657476090259

1473 E State Rd
44 Suite 1
Connersville, IN 47331-8375
Phone (765) 747-6090

3500 W Purdue Ave
Muncie, IN 47304-6357
Phone 7657476090206

830 Sim Hodgin Pkwy
Richmond, IN 47374-1931
Phone (765) 747-6090

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Wallace University PastSince Jan 17, 2022 Accepting new patients

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1891456877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172005",
            "telephone_number": "440-826-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

Verify at the official NPI Registry.