Mr. David L Miller
Physician Assistant (Medical)

Address: 80 B Veterans Blvd, Acoma, NM 87034
Phone: 5055525300

Mr. David L Miller (NPI# 1770699407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1770699407
Entity Type Individual
Full Name Mr. David L Miller
Credential PA-C
Gender Male
Practice Address 80 B Veterans Blvd
Acoma
NM 87034
Practice Telephone 5055525300
Practice Fax Number 5055525490
Mailing Address Po Box 130
San Fidel
NM 87049-0130
Mailing Telephone 5055525300
Mailing Fax Number 5055525490
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-08-23
Last Update Date 2016-12-08

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 363AM0700X Physician Assistant · Medical Physician Assistants & Advanced Practice Nursing Providers PA03057 TX
No 363AM0700X Physician Assistant · Medical Physician Assistants & Advanced Practice Nursing Providers PA.200433 LA
Yes 363AM0700X Physician Assistant · Medical Physician Assistants & Advanced Practice Nursing Providers PA2015-0004 NM

Other Provider Identifier

State Identifier Issuer Type Code
TX PA03057 OTHER TEXAS BOARD OF MEDICAL EXAMINERS
NM H3451 MEDICAID
NM PA 2015-0004 OTHER PA LICENSE
LA PA.200433 OTHER LOUISIANA BOARD OF MEDICAL EXAMINERS

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NPI Name Taxonomy Address Enumeration
1558860072 David Mark Miller Emergency Medical Technician, Paramedic 7103 S Western Ave, Oklahoma City, OK 73139-2003 2018-02-10
1164958617 David Miller Student in an Organized Health Care Education/Training Program Psc 41 Box 3787, Apo, AE 09464-3787 2017-05-03
1962855239 David Miller Specialist/Technologist 917 Bellevue Pl, Jackson, MS 39202-2702 2016-07-21
1356703292 David Wayne Miller Counselor 8692 La Grand Ave, Garden Grove, CA 92841-1011 2016-03-21
1902261480 David Miller Social Worker 6605 Hammersmith Dr, Raleigh, NC 27613-3311 2015-12-28
1669855011 David Miller Dentist 131 Atlantic Ave, Unit B, Hampton, VA 23664-1095 2015-07-02
1033506506 David Miller Marriage & Family Therapist 313 Price Pl Ste 111, Madison, WI 53705-3262 2015-04-22
1205235405 David Miller Dentist 671 Country Club Rd, Lake Oswego, OR 97034-2158 2014-08-14
1982026233 David Miller Massage Therapist 2721 E 42nd St Ste B, Minneapolis, MN 55406-3071 2014-01-06
1225371529 David Siebert Miller Student in an Organized Health Care Education/Training Program 813 Edgewood Ave, New Haven, CT 06515-2216 2013-04-04
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Physician Overview

NPI 1770699407
PAC ID by PECOS 2668578477
Professional Enrollment ID I20070510000288
Full Name David L Miller
Organization Legal Name ACOMA-CANONCITO-LAGUNA INDIAN
Phone Number 5055525300
Gender M
Credential PA
Graduation Year 2001
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 8426951682
Number of Group Practice Members 19
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
320070 ACOMA-CANONCITO-LAGUNA IHS HOSPITAL

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1992981609 Brenda Y Pacheco Physician Assistant 80 B Veterans Blvd, Acoma, NM 87034 2008-01-11
1831105287 Noreen Tresa Jack-mooney Physician Assistant 80 B Veterans Blvd, I-40, Exit 102, Acoma, NM 87034 2006-07-31
1346225737 Anita D Chapman Physician Assistant 80 B Veterans Blvd, I-40, Exit 102, Acoma, NM 87034 2005-12-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1710536404 Juanita Raquel Martinez Physician Assistant 715 Dr Martin Luther King Jr Ave Ne Ste 301, Albuquerque, NM 87102-3668 2019-09-05
1366954190 Alyce Lynn Dechant Physician Assistant 1101 -4 Medical Arts Ave Ne, Albuquerque, NM 87131-0001 2017-11-02
1053836809 Alysha Gallegos Physician Assistant 6112 Molinero Ct Sw, Albuquerque, NM 87105-6814 2017-08-13
1134572738 Weston Bradley Graff Physician Assistant 703 Christopher Dr, Belen, NM 87002-2617 2016-07-19
1295194629 Ryan Grange Physician Assistant 1851 Old Highway 66 Unit 1, Edgewood, NM 87015 2016-02-12
1528452208 Taylor Bottari Physician Assistant 208 W Dl Ingram, Cannon Afb, NM 88103 2015-03-20
1336543115 Pamela O Black Md, P.a., Dba Quadra Health Institute Physician Assistant 3820 Commons Ave Ne # M, Albuquerque, NM 87109-5831 2014-10-22
1629482989 Medhat A. El-sabawy Physician Assistant 1100 Lead Se, Pmg Gi, Albuquerque, NM 87106-5215 2014-06-15
1396155206 Jennifer Brynn Bendokas Physician Assistant 224 West Dl Ingram Avenue, Cannon Afb, NM 88103 2014-04-30
1972859403 Cody W Lewis Physician Assistant 5600 Eubank Blvd Ne Ste 110, Albuquerque, NM 87111 2012-08-02
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Office Location

Street Address 80 B VETERANS BLVD
City ACOMA
State NM
Zip Code 87034

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972961068 Aline Bayard Nurse Practitioner 80 B Veterans Blvd, Acoma, NM 87034 2016-02-03
1093188724 Janet E Dominguez Nurse Practitioner 80 B Veterans Blvd, Acoma, NM 87034 2015-11-03
1124491949 Patricia A Monroe Nurse Practitioner 80 B Veterans Blvd, Acoma, NM 87034 2015-11-02
1033594122 Hlengiwe Lindani Sibanda Nurse Practitioner 80 B Veterans Blvd, Acoma, NM 87034-0536 2015-07-30
1851774392 Caleb Vanderveen Family Medicine 80 B Veterans Blvd, Acoma, NM 87034 2015-07-01
1669721122 Shawn P Giorgianni Emergency Medical Technician, Paramedic 80 B Veterans Blvd, Acl-ihs, Acoma, NM 87034 2012-08-30
1568748218 Joshua R. Ulibarri Dentist 80 B Veterans Blvd, Acoma, NM 87034 2011-10-26
1477832590 Nadezda A Tretyakova General Practice 80 B Veterans Blvd, I-40, Exit 102, Acoma, NM 87034 2011-08-07
1679893374 Mariana Mejia Botero Family Medicine 80 B Veterans Blvd, Acoma, NM 87034 2010-06-03
1811212780 Lisa S Schuerman Nurse Practitioner 80 B Veterans Blvd, Acoma, NM 87034 2010-04-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1700340841 Thomas Simon Vallo Case Manager/Care Coordinator 45 Pinbaari Drive, Acoma, NM 87034 2019-01-23
1649777053 Amanda Jean Garcia Counselor 99b Sunrise Rd, Pueblo of Acoma, NM 87034 2018-04-11
1356850754 Korey B Still Dentist 80 B Veterans Blvd., Acoma, NM 87034 2017-09-28
1508395278 Shelby Bobelu Social Worker 45 Pinsbarri Dr., Acoma, NM 87034 2017-06-07
1558817270 Amanda Lucario Technician, Other 1253 Haaku Road, Acoma, NM 87034 2016-09-01
1073961355 Rhayna Dannielle Walizer Social Worker 45 Pinsbarri Dr, Acoma, NM 87034 2016-05-27
1417305715 Everett Chavez Counselor 45 Pinsbaari, Acoma, NM 87034 2016-05-26
1952758047 Lonnie Lewis Counselor 33 Pinsbaari Drive, Acoma, NM 87034 2016-05-18
1396102505 Arianna Trott Counselor 80-b Veterans Blvd, Acomita, NM 87034 2016-01-19
1750687919 Matilda Begay Counselor 45 Pinsbaari Drive, Acoma, NM 87034 2011-02-07
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Competitor

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City ACOMA
Zip Code 87034

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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