Justin Tyler Miracle
NPI 1497354880ActiveIndividual· Pharmacist· Corvallis, OR
Pharmacist in Corvallis, Oregon, licensed in OR, with an NPI issued in October 2020. Part D covered 229 prescriptions written in 2024, 0% of them generic.
Overview
| NPI | 1497354880 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Oct 18, 2020 |
| Last updated in NPPES | Nov 15, 2023 |
| Certified by provider | Nov 15, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist Primary | 183500000X | RPH0018483 | OR |
| Student in an Organized Health Care Education/Training Program | 390200000X | PI-0013024 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 229 · 229 30-day fills |
|---|---|
| Patients | 199 |
| Total drug cost | $51,264 |
| Generic share | 0% of claims |
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