Individual provider Active NPI

Ivan Miller, MD

  • Emergency Medicine Physician
  • Belleville, NJ
National Provider Identifier
1235176512
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
217211 Issued in NY
Practice address
1 Clara Maass Dr
Clara Maass Medical Center (Emergency Department)
Belleville, NJ 07109-3550
Phone
(973) 450-2100
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 217211 NY Primary
Emergency Medicine Physician 207P00000X 25MA07413300 NJ

Addresses

Primary practice location

1 Clara Maass Dr
Clara Maass Medical Center (Emergency Department)
Belleville, NJ 07109-3550

Mailing address

PO Box 717
Livingston, NJ 07039-0717
Phone (973) 740-0607

Other identifiers 1

IdentifierTypeStateIssuer
8852901MedicaidNJ

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
I20041124000318 NY Practitioner - Emergency Medicine 3971416686 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07413300NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Medical Associates New York PC Emergency Medicine CurrentSince Dec 23, 2024 Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine Current Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Nov 25, 2021 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Nov 25, 2021 Accepting new patients
Emergency Medical of Westchester PC Emergency Medicine Past Accepting new patients
Emergency Medical Associates of New Jersey PA Emergency Medicine PastSince May 10, 2020 Accepting new patients
Dr. Gerald a. Esmond, DPM,PC Past Accepting new patients
Emergency Medical Associates of New Jersey PA Emergency Medicine Past Accepting new patients
Levin Valencia Podiatry PLLC Past Accepting new patients
Metro Emergency Medical Association PLLC Emergency Medicine Past Accepting new patients
Emergency Medical Metro P C Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600

396 Broadway
Kingston, NY 12401
Phone (845) 331-3131

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

Interoperability endpoints

  • Direct secure messaging: milleri@hiemail.healtheconnections.org

Organizations & group practices 11

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1235176512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 717",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070390717",
            "telephone_number": "973-740-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CLARA MAASS DR",
            "address_2": "CLARA MAASS MEDICAL CENTER (EMERGENCY DEPARTMENT)",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071093550",
            "telephone_number": "973-450-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "IVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "217211",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA07413300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8852901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, NJ

Sources for this page

Verify at the official NPI Registry.