Individual provider Active NPI

George Walter Miller Jr., M.D.

  • Family Medicine Physician
  • Verona, NJ
National Provider Identifier
1316942618
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA03913700 Issued in NJ
Practice address
799 Bloomfield Ave Ste 201
Verona, NJ 07044-1301
Phone
(973) 746-7050
Fax
(973) 857-2831
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA03913700 NJ Primary

Addresses

Primary practice location

799 Bloomfield Ave Ste 201
Verona, NJ 07044-1301

Mailing address

33 Mountainside Dr
Wayne, NJ 07470-4208
Phone (973) 628-0427

Other identifiers 1

IdentifierTypeStateIssuer
7241607MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03913700NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Care of Practice Associates,PA Past Accepting new patients
St. Joseph'S Healthcare, Inc. Past Accepting new patients
Practice Associates,Inc Family Medicine Past Accepting new patients

Organizations & group practices 3

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1316942618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MOUNTAINSIDE DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704208",
            "telephone_number": "973-628-0427",
            "fax_number": "973-872-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 BLOOMFIELD AVE STE 201",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441301",
            "telephone_number": "973-746-7050",
            "fax_number": "973-857-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GEORGE",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA03913700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7241607",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.