MOLLIE T MILLER – Obstetrics & Gynecology Physician, NPI 1053638064

MOLLIE T MILLER is a healthcare provider. based in Canon city, Colorado. specializing in OBSTETRICS/GYNECOLOGY. They hold a License No. DR.0048291 (CO). The NPI Number for MOLLIE T MILLER is 1053638064

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
MOLLIE T MILLER
NPI
1053638064
Phone
(719) 285-2700
Address
1339 PHAY AVE
Enumeration Date
29 April 2010
Last Update Date
16 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7197764780
Graduation Year
2002 (24 years ago)
PAC ID
1052435732
Group Practice PAC ID
8022927342
Professional Enrollment ID
I20100901000949
Address ID
CO808635008WO41XXX67XX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness85
Years active:16State licenses:1Digital endpointsOther names

824 OBSTETRICS/GYNECOLOGY in CO

Provider Addresses for MOLLIE T MILLER

  • 1339 PHAY AVE

    CANON CITY, CO 812122301

    Phone: (719) 285-2700

    Fax: (719) 285-2455

    Type: Location

  • DEPT 1057

    DENVER, CO 802911057

    Phone: (303) 486-5500

    Fax: (303) 486-5502

    Type: Mailing

  • 1338 PHAY AVE

    CANON CITY, CO 812122311

    Phone: (719) 285-2700

    Fax: (719) 285-2455

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100901000949IObstetrics/GynecologyCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 81212)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022927342View full group profile
NameSpecialtyState
Physician AssistantCO
Radiation OncologyTX
-CO
Hospitalist, General Practice, Family PracticeCO
Cardiovascular Disease (Cardiology)NM
Family PracticeOK
Internal MedicineCO
-IL
H E M A T O L O G Y/ O N C O L O G YTX
Internal MedicinePA

Reviews

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Frequently asked questions

Is there an official ID for MOLLIE T MILLER in U.S. healthcare records?
The official identifier for MOLLIE T MILLER is NPI 1053638064.
Is there an active status for MOLLIE T MILLER?
For scheduling context, MOLLIE T MILLER is shown as active in the registry.
What kind of doctor is MOLLIE T MILLER?
MOLLIE T MILLER is associated with Obstetrics & Gynecology Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with MOLLIE T MILLER?
Directory geography for MOLLIE T MILLER centers on Canon City, Colorado.
When was this NPI issued?
Enumeration for MOLLIE T MILLER is noted as April 29, 2010 where the registry provides it.

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