NPIMap

Individual provider Active NPI

Tyrone J Miller, DO

  • Surgery Physician
  • Tyler, TX
National Provider Identifier
1952513202
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
P5423 Issued in TX
Practice address
1040 S Fleishel Ave Ste 1
Tyler, TX 75701-2031
Phone
(903) 533-8702
Fax
(903) 533-8720
NPI assigned
May 7, 2007
Last updated
Feb 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101016911 MI
Surgery Physician 208600000X P5423 TX Primary
Vascular Surgery Physician 2086S0129X P5423 TX

Addresses

Primary practice location

1040 S Fleishel Ave Ste 1
Tyler, TX 75701-2031

Mailing address

1040 S Fleishel Ave Ste 1
Tyler, TX 75701-2031
Phone (903) 533-8702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130913000277 TX Practitioner - General SurgeryPractitioner - Vascular Surgery 1557539335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Arizona College of Osteopathic Medicine Mid Western University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Varicose vein removal46
Leg revascularization (restoring blood flow)42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Jan 1, 2025 Accepting new patients
Mark Robbins MD PA Surgery CurrentSince Jun 1, 2015 Accepting new patients
Etmc Physician Group Inc. CurrentSince Jan 1, 2025 Accepting new patients
East Texas Medical Center Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1002 N Mound St
Nacogdoches, TX 75961
Phone (936) 560-3800

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1040 S Fleishel Ave
Tyler, TX 75701
Phone (903) 533-8702

1040 S Fleishel Ave
Ste 1
Tyler, TX 75701
Phone (903) 533-8702

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

Organizations & group practices 4

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 8

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1952513202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S FLEISHEL AVE STE 1",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012031",
            "telephone_number": "903-533-8702",
            "fax_number": "903-533-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S FLEISHEL AVE STE 1",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012031",
            "telephone_number": "903-533-8702",
            "fax_number": "903-533-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TYRONE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101016911",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "P5423",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "P5423",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.