Individual provider Active NPI

Eric Jonathan Miller, MD

  • Internal Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1508494998
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
324353 Issued in NY
Practice address
100 Nicholls Rd
Health Science Center T16 Room 020
Stony Brook, NY 11790-8160
Phone
(631) 444-7411
Fax
(631) 444-2493
NPI assigned
Mar 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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 324353 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

100 Nicholls Rd
Health Science Center T16 Room 020
Stony Brook, NY 11790-8160

Mailing address

100 Nicholls Rd
Health Science Center T16 Room 020
Stony Brook, NY 11790-8160
Phone (631) 444-7411

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821000605 NY Practitioner - Hospitalist 7416319678

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital at Stony Brook Past Accepting new patients

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1508494998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICHOLLS RD",
            "address_2": "HEALTH SCIENCE CENTER T16 ROOM 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117908160",
            "telephone_number": "631-444-7411",
            "fax_number": "631-444-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICHOLLS RD",
            "address_2": "HEALTH SCIENCE CENTER T16 ROOM 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117908160",
            "telephone_number": "631-444-7411",
            "fax_number": "631-444-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ERIC",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "324353",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.