Kelly Marisa Miller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

020187 Issued in NY

Practice address

1101 Nott St
Schenectady, NY 12308-2425

Phone

(518) 243-4001

NPI assigned

Sep 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kelly.miller@ushv.eclinicaldirectplus.com

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.

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Medicare reassignment

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1144779489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 NOTT STREET",
            "address_2": "CATH LAB A2",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12308",
            "telephone_number": "518-243-4001",
            "fax_number": "182-434-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NOTT ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082425",
            "telephone_number": "518-243-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2546 Balltown Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123091083",
            "country_code": "US",
            "telephone_number": "518-377-8184",
            "fax_number": "518-374-5918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLY",
        "middle_name": "MARISA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2024-01-02",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Miller, PH.D.
• Beatrice E Miller, NP
• Craig F Miller, P.A.
• Danielle Miller, LMSW
• Grace Elizabeth Miller
• Kiana Ajee Miller, MSW, LMSW
• Kristen Miller
• Lisa Miller
• Nelson Miller
• Roberta N Miller, MD

• Physician Assistant in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.