Organization Active NPI

Stuart P Miller, MD, PA

  • Specialist
  • Melbourne, FL
National Provider Identifier
1043410327
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0049094 Issued in FL
Legal business name
STUART P MILLER, MD, PA
Practice address
301 Sheridan Rd
Melbourne, FL 32901-3160
Phone
(321) 951-8137
Fax
(321) 951-8138
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Ann M Miller
Title
Office Manager
Phone
(321) 951-8137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME0049094 FL Primary

Addresses

Primary practice location

301 Sheridan Rd
Melbourne, FL 32901-3160

Mailing address

301 Sheridan Rd
Melbourne, FL 32901-3160
Phone (321) 951-8137

Other identifiers 1

IdentifierTypeStateIssuer
K5334OtherFLMEDICARE TPAN NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421001746 FL Part B Supplier - Clinic/Group Practice 8527054931 Receives reassigned benefits from 1 practitioner
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

301 Sheridan Rd
Melbourne, FL 32901
Phone (321) 951-8137

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1043410327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013160",
            "telephone_number": "321-951-8137",
            "fax_number": "321-951-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013160",
            "telephone_number": "321-951-8137",
            "fax_number": "321-951-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUART P MILLER, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "321-951-8137",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0049094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TPAN NUMBER",
            "identifier": "K5334",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.