Individual provider Active NPI

David Roy Miller, M.D.

  • Family Medicine Physician
  • Agoura Hills, CA
National Provider Identifier
1912958257
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A54820 Issued in CA
Practice address
28240 Agoura Rd
Suite 102
Agoura Hills, CA 91301-2485
Phone
(818) 706-9690
Fax
(818) 706-9692
NPI assigned
May 12, 2006
Last updated
Feb 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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 A54820 CA Primary

Addresses

Primary practice location

28240 Agoura Rd
Suite 102
Agoura Hills, CA 91301-2485

Mailing address

28240 Agoura Rd
Suite 102
Agoura Hills, CA 91301-2485
Phone (818) 706-9690

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20070119000327 CA Practitioner - Family Practice 8022019934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

28240 Agoura Rd
Suite 102
Agoura Hills, CA 91301-2468
Phone (818) 706-9690

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A54820CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miller Medical & Wellness Clinic a Professional Medical Corp Family Medicine CurrentSince Dec 1, 2006 Accepting new patients

Locations

28240 Agoura Rd
Ste 102
Agoura Hills, CA 91301
Phone (818) 706-9222

Interoperability endpoints

  • Direct secure messaging: david.miller.1@29381.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1912958257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28240 AGOURA RD",
            "address_2": "SUITE 102",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012485",
            "telephone_number": "818-706-9690",
            "fax_number": "818-706-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28240 AGOURA RD",
            "address_2": "SUITE 102",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012485",
            "telephone_number": "818-706-9690",
            "fax_number": "818-706-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DAVID",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A54820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

Verify at the official NPI Registry.