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JACK EDWIN MILLER MD
NPI 1497824627
Psychiatry & Neurology - Neurology in Petaluma, CA

Active since November 06, 2006PECOS Enrolled
765 BAYWOOD DR, #231, PETALUMA, CA 94954(707) 762-2166(707) 766-8160 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jack Edwin Miller Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK EDWIN MILLER MD (NPI 1497824627) is an individual neurology provider in Petaluma, California, licensed in California (G26214) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1497824627
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameJACK EDWIN MILLERCredential: MD
Location Address765 BAYWOOD DR, #231Petaluma, CA 94954
Mailing Address765 Baywood Dr, #231Petaluma, CA 94954 · (707) 762-2166 · Fax (707) 766-8160
Phone(707) 762-2166
Fax(707) 766-8160
Sole ProprietorNo
Enumeration DateNovember 6, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1497824627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in CA · G26214
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
765 BAYWOOD DR, Petaluma, CA 94954
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Other Identifiers 1

Medicare UPING13557

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Edwin Miller Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94954 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$142.00 typical visit price
range $63.04 – $187.01
Typical copayment $35.50 (range $15.76 – $46.75)
Most-billed visit code 99204
Established Patient
$109.88 typical visit price
range $21.02 – $153.40
Typical copayment $27.47 (range $5.25 – $38.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHRISTOPHER MICHAEL ROSENTHAL DDS
Dentist (General Practice)
765 BAYWOOD DR, SUITE 233
PETALUMA, CA 94954
Sonoma County (707) 763-9841

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Miller's NPI number?

The NPI number for Jack Miller is 1497824627. It was assigned to this individual provider in the NPPES registry on November 6, 2006.

Where is Jack Miller located?

Jack Miller practices at 765 Baywood Dr #231, Petaluma, CA 94954. The listed phone number is (707) 762-2166.

What is Jack Miller's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Jack Miller enrolled in Medicare?

Yes. Jack Miller is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Miller was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.