NPIMap

Individual provider Active NPI

Mitchell B Miller, MD

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1902809437
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101032190 Issued in VA
Practice address
2109 McComas Way
Ste 102
Virginia Beach, VA 23456-3909
Phone
(757) 563-2800
Fax
(757) 563-2300
NPI assigned
May 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101032190 VA Primary

Addresses

Primary practice location

2109 McComas Way
Ste 102
Virginia Beach, VA 23456-3909

Mailing address

2109 McComas Way
Ste 102
Virginia Beach, VA 23456-3909
Phone (757) 563-2800

Other identifiers 4

IdentifierTypeStateIssuer
080150542OtherVARAILROAD MEDICARE
005643350MedicaidVA
208896OtherVAANTHEM
37450OtherVAOPTIMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040806000944 VA Practitioner - Family Practice 5395717706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Family Practice PCGroup PAC ID 6305908716, 3 clinicians

Practice addresses (Care Compare)

2109 McComas Way
Suite 102
Virginia Beach, VA 23456-3909
Phone (757) 563-2800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.03 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
76.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Family Practice PC Family Medicine CurrentSince Jun 1, 2000 Accepting new patients

Locations

2109 McComas Way
Ste 102
Virginia Beach, VA 23456
Phone (757) 563-2300

Organizations & group practices 1

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": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1902809437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 MCCOMAS WAY",
            "address_2": "STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563909",
            "telephone_number": "757-563-2800",
            "fax_number": "757-563-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 MCCOMAS WAY",
            "address_2": "STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563909",
            "telephone_number": "757-563-2800",
            "fax_number": "757-563-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MITCHELL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-30",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101032190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080150542",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005643350",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "208896",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "37450",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.