Provider Demographics
NPI:1225023138
Name:MILLER, JASON ROY (DPM)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ROY
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5228
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-0405
Mailing Address - Country:US
Mailing Address - Phone:610-359-5672
Mailing Address - Fax:
Practice Address - Street 1:266 LANCASTER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3256
Practice Address - Country:US
Practice Address - Phone:610-644-6900
Practice Address - Fax:610-644-7160
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004376L213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3713551000OtherKEYSTONE HEALTH PLAN EAST
PAP11165423OtherMULTI-PLAN
PA0018674920001Medicaid
PA1867492Medicaid
PA439335OtherHEALTH AMERICA HEALTH ASSURANCE
PAA309007OtherINTER CITY
PAMI1309007OtherBLUE SHIELD OF PA
PA30014074OtherKEYSTONE MERCY
PA480032097OtherRAILROAD MEDICARE
PAP2570271OtherOXFORD
PA2624731OtherAETNA
PA7658OtherELDER HEALTH / BRAVO
NJ8610002OtherNJ MEDICAL ASSISTANCE
PA202259000OtherKEYSTONE HEALTH PLAN HMO
PA231365971OtherHUMANA
PA2Y9621OtherHEALTH NET
PA4039264001OtherCIGNA
PA951765OtherKEYSTONE HEALTH PPO
PA231365971071OtherTRI-CARE
PA288224OtherHEALTH PARTNERS
PA480032097OtherRAILROAD MEDICARE
PAA309007OtherINTER CITY
PAMI1309007OtherBLUE SHIELD OF PA