Individual provider Active NPI

Eileen Miller, RN-ANP

  • Home Health Registered Nurse
  • Woodside, NY
National Provider Identifier
1073816526
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
278145 Issued in NY
Practice address
6110 Queens Blvd
Woodside, NY 11377-5776
Phone
(718) 397-2002
NPI assigned
Dec 6, 2010
Last updated
Dec 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 278145 NY Primary

Addresses

Primary practice location

6110 Queens Blvd
Woodside, NY 11377-5776

Mailing address

5852 212TH St
Bayside Hills, NY 11364-1822
Phone (718) 279-3306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180118000130 NY Practitioner - Nurse Practitioner 9931468022 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
278145NYMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Medical PLLC CurrentSince Nov 15, 2017 Accepting new patients

Locations

3712 Prince St
Ste 3C
Flushing, NY 11354
Phone (718) 380-7800

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1073816526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5852 212TH ST",
            "city": "BAYSIDE HILLS",
            "state": "NY",
            "postal_code": "113641822",
            "telephone_number": "718-279-3306",
            "fax_number": "718-279-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 QUEENS BLVD",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113775776",
            "telephone_number": "718-397-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EILEEN",
        "credential": "RN-ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "278145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.