Individual provider Active NPI

Alice Miller, MD

  • Family Medicine Physician
  • Camillus, NY
National Provider Identifier
1528244555
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
252811 Issued in NY
Practice address
436 Hinsdale Rd
Camillus, NY 13031-1648
Phone
(315) 488-0996
Fax
(315) 488-1955
NPI assigned
Jan 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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 252811 NY Primary

Addresses

Primary practice location

436 Hinsdale Rd
Camillus, NY 13031-1648

Mailing address

1001 W Fayette St
Ste 400
Syracuse, NY 13204-2859
Phone (315) 472-1488

Other identifiers 1

IdentifierTypeStateIssuer
252811OtherNYNY ST LICENSE

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
I20090807000403 NY Practitioner - Family Practice 4880747898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Familycare Medical Group PCGroup PAC ID 5193639565, 110 clinicians

Practice addresses (Care Compare)

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2866
Phone (315) 472-1488

436 Hinsdale Rd
Camillus, NY 13031-1648
Phone (315) 488-0996

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Familycare Medical Group, PC Family Medicine CurrentSince Aug 15, 2009 Accepting new patients

Locations

436 Hinsdale Rd
Camillus, NY 13031
Phone (315) 488-0996

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

Interoperability endpoints

  • Direct secure messaging: amiller@fcmg.medentdirect.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1528244555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-472-1488",
            "fax_number": "315-472-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 HINSDALE RD",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311648",
            "telephone_number": "315-488-0996",
            "fax_number": "315-488-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "252811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY ST LICENSE",
            "identifier": "252811",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

Verify at the official NPI Registry.