NPIMap

Individual provider Active NPI

Edward J Miller, MD

  • Internal Medicine Physician
  • Youngstown, OH
National Provider Identifier
1891763355
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35069170 Issued in OH
Practice address
7641 Market St
Suite 2
Youngstown, OH 44512-6010
Phone
(330) 884-2444
Fax
(330) 965-4836
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35069170 OH Primary

Addresses

Primary practice location

7641 Market St
Suite 2
Youngstown, OH 44512-6010

Mailing address

7629 Market St
Suite 200
Youngstown, OH 44512-6075
Phone (330) 965-4540

Other identifiers 1

IdentifierTypeStateIssuer
2110003MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081028000048 OH Practitioner - Internal Medicine 3779641212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

7629 Market St
Suite 100
Youngstown, OH 44512-6051
Phone (330) 729-8015

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
71.12
Promoting interoperability
100
Improvement activities
40
Cost
75.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35069170OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Health Services, LLC Internal Medicine CurrentSince Apr 1, 2015 Accepting new patients
Southwoods Health at Home, LLC PastSince Sep 1, 2021 Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Locations

7629 Market St
Ste 200
Youngstown, OH 44512
Phone (330) 729-8000

7629 Market St
Ste 250
Youngstown, OH 44512
Phone (330) 729-9480

7641 Market St
Ste 2
Youngstown, OH 44512
Phone (330) 726-0156

500 Gypsy Ln
Youngstown, OH 44504
Phone (330) 740-4572

100 Debartolo Pl
Ste 200
Youngstown, OH 44512
Phone (330) 965-7828

7629 Market St
Ste 100
Youngstown, OH 44512
Phone (330) 792-0583

Organizations & group practices 3

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 7

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1891763355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7629 MARKET ST",
            "address_2": "SUITE 200",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126075",
            "telephone_number": "330-965-4540",
            "fax_number": "330-965-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7641 MARKET ST",
            "address_2": "SUITE 2",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126010",
            "telephone_number": "330-884-2444",
            "fax_number": "330-965-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35069170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2110003",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.