Michael Miller, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

049621-01 Issued in NY

Practice address

5320 W Genesee St
Camillus, NY 13031-2268

Phone

(315) 469-5400

NPI assigned

Dec 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Reilley Physical Therapy, PLLC

  • Physical Therapist
  • Freeville, NY
  • NPI 1003425968
  Medicare reassignment NPD
• Sports Physical Therapy of New York, P.C.

  • Physical Therapist
  • Manlius, NY
  • NPI 1912950072
  Medicare reassignment NPD

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1053023739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3408 HAMMOCKS DR APT 206",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130274228",
            "telephone_number": "716-697-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312268",
            "telephone_number": "315-469-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049621-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie McMillen, PHD, CCC-SLP
• Morgan Leigh McNulty, MS, OTR/L
• Haleigh Michaud, DPT
• Cherie L Milazzo
• Alice Miller, MD
• Debra A Mirabito, NP
• Nicole Louise Mitchell, D.C.
• Angela Monico, CASAC
• Kerry Morse, LPN
• Shauna Marie Mulpagano, L.P.N.

• Physical Therapist in Camillus, NY
• Providers in Camillus, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.