Individual provider Active NPI

Arielle Miller

  • Physician Assistant
  • Ridgewood, NJ
National Provider Identifier
1629500657
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
NJDACTEMP-031400 Issued in NJ
Practice address
1124 E Ridgewood Ave Ste 202
Ridgewood, NJ 07450-3943
Phone
(201) 493-1717
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020257-1 NY
Physician Assistant 363A00000X NJDACTEMP-031400 NJ Primary

Addresses

Primary practice location

1124 E Ridgewood Ave Ste 202
Ridgewood, NJ 07450-3943

Mailing address

1124 E Ridgewood Ave Ste 202
Ridgewood, NJ 07450-3943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201209000321 NJ Practitioner - Physician Assistant 7012329436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of New Jersey PCGroup PAC ID 4082754759, 12 clinicians

Practice addresses (Care Compare)

52 Deforest Ave
Summit, NJ 07901-1930
Phone (908) 516-2135

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
020257-1NYMDSpeech-Language Pathologist
NJDACTEMP-031400NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Paige Applebaum Farkas MD PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amiller@advderm.emadirect.md

Organizations & group practices 2

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": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1629500657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E RIDGEWOOD AVE STE 202",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 E RIDGEWOOD AVE STE 202",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503943",
            "telephone_number": "201-493-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ARIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020257-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "NJDACTEMP-031400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.