Jacob Daniel Miller (NPI# 1619105871, PAC ID# 1254653306) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1619105871 |
| PAC ID by PECOS | 1254653306 |
| Professional Enrollment ID | I20170228000471 |
| Full Name | Jacob Daniel Miller |
| Organization Legal Name | PROMEDICA CENTRAL PHYSICIANS LLC |
| Address |
1250 Ralston Ave Suite 104 Defiance OH 43512-5308 |
| Phone Number | 4197837300 |
| Gender | M |
| Medical School | WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2009 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 2365348190 |
| Number of Group Practice Members | 653 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360048 | UNIVERSITY OF TOLEDO MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1250 Ralston Ave, Suite 104, Defiance, OH 43512-5308 | 4197837300 | PROMEDICA CENTRAL PHYSICIANS LLC |
| 3000 Arlington Ave, Toledo, OH 43614-2595 | 4193833578 | UNIVERSITY OF TOLEDO PHYSICIANS LLC |
| Organization Legal Name | PROMEDICA CENTRAL PHYSICIANS LLC |
| Physicians | 683 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marwa El-bohy | Pediatric Medicine | Promedica Central Physicians LLC | 6005 Monclova Rd, Suite 320, Maumee, OH 43537-1862 |
| Holly Hapner | Family Medicine | Promedica Central Physicians LLC | 1601 Brigham Dr, 250a, Perrysburg, OH 43551-7115 |
| Lisa L Bainter | Nurse Practitioner | Promedica Central Physicians LLC | 2109 Hughes Dr, Suite 760, Toledo, OH 43606-5111 |
| Lori Ann Schuh | Neurology | Promedica Central Physicians LLC | 2130 W Central Ave, Toledo, OH 43606-3834 |
| Laura R Rejent | Physician Assistant | Promedica Central Physicians LLC | 5700 Monroe St, Sylvania, OH 43560-2767 |
| Phebe E Shawver | Nurse Practitioner | Promedica Central Physicians LLC | 3316 Navarre Ave, Suite F, Oregon, OH 43616-3314 |
| Dani Zoorob | Obstetrics/gynecology | Promedica Central Physicians LLC | 501 Van Buren St, Fostoria, OH 44830-1534 |
| Benjamin Assenmacher | Orthopedic Surgery | Promedica Central Physicians LLC | 2751 Bay Park Dr, Suite 201, Oregon, OH 43616-4922 |
| Jordan M Siewert | Family Medicine | Promedica Central Physicians LLC | 217 Golden Gate Plz, Maumee, OH 43537-2881 |
| Alisa Marie Lopez | Nurse Practitioner | Promedica Central Physicians LLC | 5308 Harroun Rd, Suite 180, Sylvania, OH 43560-2193 |
| Street Address |
1250 RALSTON AVE SUITE 104 |
| City | DEFIANCE |
| State | OH |
| Zip | 43512-5308 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Beth Alexander Besaw | Family Medicine | Promedica Central Physicians LLC | 1250 Ralston Ave, Defiance, OH 43512-5308 |
| Alesha Ann Switzer | Nurse Practitioner | Promedica Central Physicians LLC | 1250 Ralston Ave, Suite 104, Defiance, OH 43512-5308 |
| Kelli M Donovan | Physician Assistant | Promedica Central Physicians LLC | 1250 Ralston Ave, Defiance, OH 43512-5308 |
| Rosemary Karen Reiter | Family Medicine | Promedica Central Physicians LLC | 1250 Ralston Ave, Defiance, OH 43512-5308 |
| Paula S Sprow | Nurse Practitioner | Promedica Central Physicians LLC | 1250 Ralston Ave, Defiance, OH 43512-5308 |
| Joshua Lucas | Family Medicine | Promedica Central Physicians LLC | 1250 Ralston Ave, Suite 104, Defiance, OH 43512-5308 |
| Martin Charles Skie | Orthopedic Surgery | Promedica Central Physicians LLC | 1250 Ralston Ave, Suite 104, Defiance, OH 43512-5308 |
| Ashley M Monk | Obstetrics/gynecology | Promedica Central Physicians LLC | 1250 Ralston Ave, Suite 104, Defiance, OH 43512-5308 |
| Michelle Egler | Nurse Practitioner | Promedica Central Physicians LLC | 1250 Ralston Ave, Suite 104, Defiance, OH 43512-5308 |
| Trevor Ward Poole | General Surgery | Promedica Central Physicians LLC | 1250 Ralston Ave, Suite 105, Defiance, OH 43512-5308 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David C Deal | Psychologist, Clinical | 1450 S Clinton, Defiance, OH 43512 | |
| Melissa R Davies | Psychologist, Clinical | 1125 Ralston Ave, Defiance, OH 43512-1336 | |
| Thomas L Flanigan | Plastic and Reconstructive Surgery | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Brenda M Brady | Psychiatry | Defiance Hospital Inc. | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Randal D Martin | Certified Registered Nurse Anesthetist (crna) | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Matthew M Reiner | Podiatry | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Jessica Lynn Saunders | Nurse Practitioner | Omni Health Services, Ltd | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Trisha K Davis | Nurse Practitioner | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Truman F Weigand Jr. | General Surgery | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Aban A Affan | Anesthesiology | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Find all physicians in zip 43512 | |||
| City | DEFIANCE |
| Zip Code | 43512 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | DEFIANCE + ORTHOPEDIC SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.