Individual provider Active NPI

Miller J Van Vliet, DO

  • Anesthesiology Physician
  • Bolivia, NC
National Provider Identifier
1891790622
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
200401590 Issued in NC
Practice address
240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone
(704) 749-5800
Fax
(704) 749-5819
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 200401590 NC Primary

Addresses

Primary practice location

240 Hospital Dr NE
Bolivia, NC 28422-8346

Mailing address

200 Providence Rd
St. 101
Charlotte, NC 28207-1468
Phone (704) 749-5800

Other identifiers 3

IdentifierTypeStateIssuer
89138J9MedicaidNC
2035752BOtherNCMEDICARE PTAN
2035752DOtherNCMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, ME, NH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20041210000651 NC Practitioner - Anesthesiology 6507757382 Reassigns benefits to 4 organizations
I20181005002126 ME Practitioner - Anesthesiology 6507757382 Reassigns benefits to 4 organizations
I20250328002484 NH Practitioner - Anesthesiology 6507757382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Philadelphia College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarmc Anesthesia Specialist LLCGroup PAC ID 5294032413, 48 clinicians
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

1144 N Rd St
Elizabeth City, NC 27909-3473
Phone (252) 335-0531

1305 Glen Meade Rd
Wilmington, NC 28401-7369
Phone (910) 815-6100

240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone (910) 721-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.02 of 100Reported as group
Quality
59.99
Promoting interoperability
99
Improvement activities
40
Cost
74.25

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sarmc Anesthesia Specialist LLC CurrentSince Mar 9, 2022 Accepting new patients
Central Maine Medical Center CurrentSince Jul 6, 2024 Accepting new patients
Wilmington Health PLLC CurrentSince Aug 25, 2025 Accepting new patients
Rumford Hospital CurrentSince Jul 6, 2024 Accepting new patients
Central Maine Medical Center CurrentSince Jul 6, 2024 Accepting new patients
Bridgton Hospital CurrentSince Jul 6, 2024 Accepting new patients
Amoskeag Anesthesia, PLLC Anesthesiology CurrentSince Mar 20, 2025 Accepting new patients
Rumford Hospital CurrentSince Jul 6, 2024 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Jan 5, 2010 Accepting new patients
Mainehealth CurrentSince Oct 22, 2018 Accepting new patients
Bridgton Hospital CurrentSince Jul 6, 2024 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Jan 5, 2010 Accepting new patients
Wilmington ASC LLC CurrentSince Aug 25, 2025 Accepting new patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Aug 1, 2012 Accepting new patients
Wilmington Anesthesiologists PLLC Anesthesiology Past Accepting new patients
Ambulatory Anesthesia Services, PLLC Anesthesiology Past Accepting new patients

Locations

118 Northport Ave
Belfast, ME 04915
Phone (207) 338-9345

116 Northport Ave
Ste 220
Belfast, ME 04915
Phone (207) 505-4015

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

200 Providence Rd
Ste 101
Charlotte, NC 28207

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

2520 Independence Blvd
Ste 200
Wilmington, NC 28412
Phone (910) 442-1100

105 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 686-2840

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

1099 Medical Center Dr
Ste 201
Wilmington, NC 28401
Phone (910) 251-9444

1305 Glen Meade Rd
Wilmington, NC 28401
Phone (910) 815-6100

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

185 Queen City Ave
Manchester, NH 03101
Phone (603) 314-6900

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • Direct secure messaging: mvanvliet27479@direct.novanthealth.org

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1891790622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PROVIDENCE RD",
            "address_2": "ST. 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071468",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VLIET",
        "first_name": "MILLER",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "200401590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89138J9",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2035752B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2035752D",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.