MR. KENNETH DOMINIQUE MILLER PA-C NPI 1275868572

NPI Information

NPI: 1275868572
Provider Name: MR. KENNETH DOMINIQUE MILLER, PA-C
Classification: Physician Assistant - 363AS0400X
Specialization: Surgical
Entity Type: Individual
PECOS Registration: Yes
Address: 875 SWIFT BLVD
RICHLAND, WA
ZIP 99352
Phone: (509) 946-1654

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NPI Details

MR. Kenneth Dominique Miller, PA-C is a surgical physician assistant in Richland, WA with 16 years of experience. MR. Kenneth Dominique Miller, PA-C NPI is 1275868572. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

875 SWIFT BLVD
RICHLAND, WA
ZIP 99352-592
Phone: (509) 946-1654
Fax: (509) 943-5652

The NPI 1275868572 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
Treatment of broken neck of thigh bone with bone implant (HCPCS:27245)
Fusion of pelvic joint using imaging guidance (HCPCS:27279)
Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
Replacement of thigh bone and hip joint with prosthesis (HCPCS:27130)
Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement (HCPCS:27236)

The enumeration date for this NPI number is 10/5/2009 and was last updated on 1/23/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		PA60115570	WASHINGTON	No
2	363AM0700X	Physician Assistant	Medical	PA60115570	WASHINGTON	No
3	363AS0400X	Physician Assistant	Surgical	PA60115570	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0016MI	OTHER	WASHINGTON	BSWA KADLEC
2	2004006	MEDICAID	WASHINGTON
3	808497500	MEDICAID	IDAHO
4	0255435	OTHER	WASHINGTON	LIWA VCR
5	P00781687	OTHER	WASHINGTON	RRGA
6	G8885960	MEDICARE PIN	WASHINGTON
7	500619959	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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