Individual provider Active NPI

Steven P Mickley, MD

  • Internal Medicine Physician
  • Greenwich, CT
National Provider Identifier
1376539205
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
016644 Issued in CT
Practice address
7 Riversville Rd
Greenwich, CT 06831-3627
Phone
(203) 531-1808
Fax
(203) 831-8326
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 016644 CT Primary
Internal Medicine Physician 207R00000X 117123 NY

Addresses

Primary practice location

7 Riversville Rd
Greenwich, CT 06831-3627

Mailing address

7 Riversville Rd
Greenwich, CT 06831-3627
Phone (203) 531-8326

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
117123NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwich Sports Medicine PC PastSince Nov 19, 2016 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: smickley6904@direct.ynhh.org

Organizations & group practices 1

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1376539205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 RIVERSVILLE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068313627",
            "telephone_number": "203-531-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 RIVERSVILLE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068313627",
            "telephone_number": "203-531-1808",
            "fax_number": "203-831-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLEY",
        "first_name": "STEVEN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "016644",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "117123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; 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.