Individual provider Active NPI

Lucas Anthony Miller, MD

  • Emergency Medicine Physician
  • Fort Drum, NY
National Provider Identifier
1932662178
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
316814 Issued in NY
Practice address
USA Meddac
11050 Mount Belvedere Blvd
Fort Drum, NY 13602
Phone
(315) 772-2778
NPI assigned
Apr 12, 2019
Last updated
May 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 316814 NY Primary

Addresses

Primary practice location

USA Meddac
11050 Mount Belvedere Blvd
Fort Drum, NY 13602

Mailing address

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (129) 435-6965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SD, GA3 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
I20230104002281 NY Practitioner - Emergency Medicine 8123356649 Reassigns benefits to 4 organizations
I20230501001526 SD Practitioner - Emergency Medicine 8123356649
I20240917000614 GA Practitioner - Emergency Medicine 8123356649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians IncGroup PAC ID 7911811435, 105 clinicians

Practice addresses (Care Compare)

2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone (912) 466-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Medical Associates New York PC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Canton-Potsdam Hospital CurrentSince Nov 17, 2022 Accepting new patients
Gouverneur Hospital CurrentSince Nov 17, 2022 Accepting new patients
Emergency Physicians Inc Emergency Medicine CurrentSince Jun 2, 2024 Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Canton-Potsdam Hospital CurrentSince Nov 17, 2022 Accepting new patients
Massena Hospital, Inc CurrentSince Nov 17, 2022 Accepting new patients
Gouverneur Hospital CurrentSince Nov 17, 2022 Accepting new patients
Massena Hospital Inc CurrentSince Nov 17, 2022 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

1 Hospital Dr
Massena, NY 13662
Phone (315) 764-1711

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Interoperability endpoints

  • Direct secure messaging: lmiller@rwicl-sd.direct.office.nextgen.com

Organizations & group practices 9

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 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": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1932662178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "129-435-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA MEDDAC",
            "address_2": "11050 MOUNT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LUCAS",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "316814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Drum, NY

Sources for this page

Verify at the official NPI Registry.