Individual provider Active NPI

Misty Jo Miller, PA-C

  • Physician Assistant
  • Portage, MI
National Provider Identifier
1902033830
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3000 Old Centre Rd
Portage, MI 49024-4883
Phone
(269) 321-7546
Fax
(269) 321-1705
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3000 Old Centre Rd
Portage, MI 49024-4883

Mailing address

3000 Old Centre Rd
Portage, MI 49024-4883
Phone (269) 321-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100116000222 MI Practitioner - Physician Assistant 3678615408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

2825 Airview Blvd
Portage, MI 49002-1802

5629 Stadium Dr a
Kalamazoo, MI 49009-1952
Phone (269) 372-1000

5629 Stadium Dr B
Kalamazoo, MI 49009-1952
Phone (269) 544-3270

5629 Stadium Dr D
Kalamazoo, MI 49009-1952
Phone (269) 372-5701

601 John St
Kalamazoo, MI 49007-5377

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Bronson Lakeview Hospital Hospital, Paw Paw, MI, CCN 231332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patholgy Services of Kalamazoo, PC Current Accepting new patients
Diagnostic Pathology Services of Southwest Michigan PC Current Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Sep 1, 2012 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

5629 Stadium Dr
Ste D
Kalamazoo, MI 49009
Phone (269) 372-5701

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

601 John St
Ste E352
Kalamazoo, MI 49007
Phone (269) 341-6475

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

Interoperability endpoints

  • Direct secure messaging: mmiller9702@direct.bronsonhg.org
  • Direct secure messaging: direct@direct.bronsonhg.org

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 2

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1902033830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 OLD CENTRE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244883",
            "telephone_number": "269-321-7546",
            "fax_number": "269-321-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 OLD CENTRE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244883",
            "telephone_number": "269-321-7546",
            "fax_number": "269-321-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MISTY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.