Individual provider Active NPI

Sherley Millet, M.D.

  • Psychiatry Physician
  • Island Park, NY
National Provider Identifier
1275686479
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
210110 Issued in NY
Practice address
1 Long Beach Rd
Island Park, NY 11558-2254
Phone
(516) 432-0300
Fax
(516) 432-8281
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 210110 NY Primary

Addresses

Primary practice location

1 Long Beach Rd
Island Park, NY 11558-2254

Mailing address

17520 Wexford Ter
#3U
Jamaica, NY 11432-2872
Phone (718) 526-0104

Other identifiers 1

IdentifierTypeStateIssuer
01981171MedicaidNY

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
I20050620001009 NY Practitioner - Psychiatry 1557306677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Health Providers of Western Queens, Inc.Group PAC ID 2163403148, 5 clinicians

Practice addresses (Care Compare)

1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone 9292737601426

4404 Queens Blvd
2ND
Sunnyside, NY 11104-2406
Phone (718) 706-1663

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Providers of Western Queens, Inc. CurrentSince May 27, 2016 Accepting new patients
Franklin Hospital Past Accepting new patients
Welllife Network Inc Past Accepting new patients
Welllife Network Inc. Past Accepting new patients
Epilepsy & Neurophysiology Medical Consulting PC PastSince Jun 1, 2017 Accepting new patients
Franklin Physician Services Past Accepting new patients

Locations

4404 Queens Blvd
Sunnyside, NY 11104
Phone (718) 706-1662

4404 Queens Blvd
Fl 2
Sunnyside, NY 11104
Phone (718) 392-3516

Organizations & group practices 7

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275686479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17520 WEXFORD TER",
            "address_2": "#3U",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322872",
            "telephone_number": "718-526-0104",
            "fax_number": "718-526-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LONG BEACH RD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115582254",
            "telephone_number": "516-432-0300",
            "fax_number": "516-432-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLET",
        "first_name": "SHERLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "210110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01981171",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Island Park, NY

Sources for this page

Verify at the official NPI Registry.