THEODORE J II MILLETTE (MD) – Pediatric Cardiology Physician, NPI 1245613082
Pediatric Cardiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
582 PEDIATRIC MEDICINE in VA
Provider Addresses for THEODORE J II MILLETTE (MD)
1215 Lee St
Charlottesville, VA 229082824
Phone: (434) 924-2335
Type: Location
1204 W Main St
Charlottesville, VA 229032824
Phone: (434) 924-5321
Fax: (434) 244-4412
Type: Location
2500 N State St
Jackson, MS 39216
Phone: (601) 984-6562
Fax: (601) 984-2086
Type: Location
4348 Electric Rd
Roanoke, VA 240180720
Phone: (540) 769-0976
Type: Location
2500 N STATE ST
JACKSON, MS 392164500
Phone: (601) 984-6562
Fax: (601) 984-2086
Type: Mailing
PO BOX 746450
ATLANTA, GA 303746450
Phone: (866) 401-3057
Fax: (318) 868-6430
Type: Mailing
1601 CENTER ST
MOBILE, AL 366041541
Phone: (251) 410-5437
Fax: (251) 434-3783
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $52.
Total Amount is formed as General ($52) + Research ($0) + Ownership ($0) = $52.
Last reported payment date: 2023-08-23 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($52).
Total Amount
$52
General + Research + Ownership
Payments
2
Total payment records
General Amount
$52
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $52 |
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: 2025-09-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230327003029 | I | Pediatric Medicine | VA | TBD |
| I20250905002270 | I | Pediatric Medicine | AL | TBD |
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.
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 22908)
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