Individual provider Active NPI

Evan T Miller, MD

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1982839296
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01069212A Issued in IN
Practice address
4725 Statesmen Dr
Ste. C-D
Indianapolis, IN 46250-5644
Phone
(317) 577-4200
NPI assigned
May 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11014750A IN
Anesthesiology Physician 207L00000X 01069212A IN Primary

Addresses

Primary practice location

4725 Statesmen Dr
Ste. C-D
Indianapolis, IN 46250-5644

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 274-0275

Other identifiers 2

IdentifierTypeStateIssuer
201067880MedicaidIN
Q00166434OtherINRAILROAD PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emiller@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20120606000044 IN Practitioner - Anesthesiology 2264696103 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Indiana University Health North Hospital Hospital, Carmel, IN, CCN 150161
  • Iu Health West Hospital Hospital, Avon, IN, CCN 150158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01069212AINMDAnesthesiology Physician
11014750AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Anesthesiology Associates, LLC Anesthesiology CurrentSince Sep 8, 2023 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Sep 12, 2021 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

1130 W Michigan St
Indianapolis, IN 46202
Phone (317) 274-0076

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1242432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1982839296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 STATESMEN DR",
            "address_2": "STE. C-D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462505644",
            "telephone_number": "317-577-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "317-274-0275",
            "fax_number": "317-274-0256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EVAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-16",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11014750A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01069212A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201067880",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "Q00166434",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emiller@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.