Active NPI
Adam Miller, PSY.D.
- Psychologist
- Hewlett, NY
National Provider Identifier
1093876070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 014877
- Practice address
- 1800 Rockaway Ave
Suite 206 C
Hewlett, NY 11557-1665 - Phone
- (516) 567-0139
- Fax
- (516) 593-3291
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 014877 | NY | Primary |
Addresses
Primary practice location
1800 Rockaway Ave
Suite 206 C
Hewlett, NY 11557-1665
Mailing address
1800 Rockaway Ave
Suite 206 C
Hewlett, NY 11557-1665
Phone (516) 567-0139
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02246239 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 23, 2021 through Nov 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1093876070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 ROCKAWAY AVE",
"address_2": "SUITE 206 C",
"city": "HEWLETT",
"state": "NY",
"postal_code": "115571665",
"telephone_number": "516-567-0139",
"fax_number": "516-593-3291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 ROCKAWAY AVE",
"address_2": "SUITE 206 C",
"city": "HEWLETT",
"state": "NY",
"postal_code": "115571665",
"telephone_number": "516-567-0139",
"fax_number": "516-593-3291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ADAM",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "014877",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02246239",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hewlett, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.