Individual provider Active NPI

Kadesha Sashauna Miller, PT

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1609494061
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045571 Issued in NY
Practice address
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone
(516) 829-0030
NPI assigned
Jul 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 045571 NY Primary

Addresses

Primary practice location

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802

Mailing address

320 Carleton Ave
Central Islip, NY 11722-4506
Phone (516) 738-9033

Other practice location 1

320 Carleton Ave
Central Islip, NY 11722-4506
Phone (631) 517-9261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200717001601 NY Practitioner - Physical Therapist in Private Practice 2163846551 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045571NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Dec 1, 2024 Accepting new patients
Reddy Care Physical Therapy PC Physical Therapist CurrentSince Aug 3, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2021 Accepting new patients
New York University CurrentSince Dec 1, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Feb 22, 2023 Accepting new patients
New York Physical Medicine Services, PC CurrentSince Jul 20, 2020 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

111 E 210th St
Bronx, NY 10467

815 Hutchinson River Pkwy
Bronx, NY 10465
Phone (718) 536-2690

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

285 Sills Rd
Bldg 5-6C
East Patchogue, NY 11772
Phone (631) 475-2858

309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900

27278 Grand Central Pkwy
Floral Park, NY 11005
Phone (516) 344-0030

800 E Gate Blvd
Garden City, NY 11530

1000 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 466-4700

475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

521 Route 111
Ste 107
Hauppauge, NY 11788
Phone (631) 724-9505

201 Moreland Rd
Ste 8
Hauppauge, NY 11788
Phone (631) 499-1800

576 Broadhollow Rd
Melville, NY 11747

22005 Hillside Ave
Queens Village, NY 11427
Phone (718) 400-8330

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

1312 Middle Country Rd
Selden, NY 11784
Phone (631) 698-6556

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 10

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": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1609494061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224506",
            "telephone_number": "516-738-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 11",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Carleton Ave",
            "address_purpose": "LOCATION",
            "city": "Central Islip",
            "state": "NY",
            "postal_code": "117224506",
            "country_code": "US",
            "telephone_number": "631-517-9261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KADESHA",
        "middle_name": "SASHAUNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.