Individual provider Active NPI

Linda Miller

  • General Practice Physician
  • Salt Lake City, UT
National Provider Identifier
1124101878
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
175844 Issued in NY
Practice address
675 E 2100 S
Salt Lake City, UT 84106-1887
Phone
(800) 366-1884
Fax
(801) 487-8197
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 175844 NY Primary
Emergency Medicine Physician 207P00000X 175844 NY

Addresses

Primary practice location

675 E 2100 S
Salt Lake City, UT 84106-1887

Mailing address

84-25 Kendrick Place
Jamaica Estates, NY 11432
Phone (800) 613-0272

Other identifiers 1

IdentifierTypeStateIssuer
267402000MedicaidMN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070530000192 NY Practitioner - Emergency Medicine 1254354855 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York at Stony Brook, School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Urgent Care of Wantagh PLLCGroup PAC ID 9234364027, 40 clinicians

Practice addresses (Care Compare)

4108 Ave U
Brooklyn, NY 11234-5120
Phone (718) 252-2582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
175844NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Sep 15, 2015 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
Optum Urgent Care, PLLC CurrentSince Feb 1, 2014 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 15, 2015 Accepting new patients
Excel Urgent Care of Wantagh PLLC CurrentSince Aug 1, 2025 Accepting new patients
Bethany Medical Clinic of New York, PLLC CurrentSince Mar 25, 2024 Accepting new patients

Locations

1305 Kings Hwy
Brooklyn, NY 11229
Phone (718) 280-5172

4108 Avenue U
Brooklyn, NY 11234
Phone (718) 252-2581

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

200 W 57th St
Ste 601
New York, NY 10019
Phone (315) 201-0621

2960 Victory Blvd
Staten Island, NY 10314
Phone (718) 370-2014

3430 Sunrise Hwy
Wantagh, NY 11793
Phone (516) 900-1600

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1124101878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84-25 KENDRICK PLACE",
            "city": "JAMAICA ESTATES",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "800-613-0272",
            "fax_number": "800-613-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061887",
            "telephone_number": "800-366-1884",
            "fax_number": "801-487-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LINDA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "175844",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "175844",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267402000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.