JUSTIN MICHAEL MILLER (PA) – Surgical Physician Assistant, NPI 1003055666

JUSTIN MICHAEL MILLER (PA) is a healthcare provider. based in Grand rapids, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 0010-01677 (NC). The NPI Number for JUSTIN MICHAEL MILLER (PA) is 1003055666

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
JUSTIN MICHAEL MILLER (PA)
NPI
1003055666
Phone
(616) 459-7101
Address
1111 LEFFINGWELL AVE NE
Enumeration Date
5 February 2009
Last Update Date
16 May 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2008 (18 years ago)
PAC ID
2769549484
Group Practice PAC ID
0941513303
Professional Enrollment ID
I20140605000442
Address ID
MI495463808GR5060XSEXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:17State licenses:2Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

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Provider Addresses for JUSTIN MICHAEL MILLER (PA)

  • 1111, Leffingwell Avenue Northeast, Grand Rapids, Kent County, Michigan, 49525, United States

    GRAND RAPIDS, MI 495256406

    Phone: (616) 459-7101

    Fax: (616) 954-6483

    Mailing address matches the actual address.

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: 2014-06-05

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
I20140605000442IPhysician AssistantMITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
22614Fusion of additional segment of spine3212$0
99214Established patient office or other outpatient visit, 30-39 minutes3228$0
99213Established patient office or other outpatient visit, 20-29 minutes2825$0
72100X-ray of lower and sacral spine, 2-3 views2617$0
22853Insertion of cage or mesh device to spine bone and disc space during spine fusion2614$0
View full utilization report →

Insurance plans in this area (ZIP 49525)

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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: 0941513303View full group profile
NameSpecialtyState
General PracticeMI
Family PracticeMI
Family PracticeMI
Physician AssistantMI
Physician AssistantIL
Nurse PractitionerMI
N E U R O L O G YNJ
N E U R O S U R G E R YIL
Internal MedicineMI
Family PracticeMI

Reviews

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Frequently asked questions

What NPI should I save for JUSTIN MICHAEL MILLER (PA)?
Save NPI 1003055666 if you need a stable reference for JUSTIN MICHAEL MILLER (PA).
Does this profile mean JUSTIN MICHAEL MILLER (PA) is currently active?
Yes — JUSTIN MICHAEL MILLER (PA) appears active in the national provider directory.
What kind of provider is JUSTIN MICHAEL MILLER (PA)?
The page reflects Surgical Physician Assistant for JUSTIN MICHAEL MILLER (PA). Clinical services aligned with this taxonomy classification.
Where does public data place JUSTIN MICHAEL MILLER (PA)?
The snapshot lists Grand Rapids, Michigan for JUSTIN MICHAEL MILLER (PA); download NPPES for the complete set.
What if Grand Rapids, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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