Individual provider Active NPI

Jill Wallis Miller-Horn, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • East Setauket, NY
National Provider Identifier
1639337504
Registry record updated Apr 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
240647 Issued in NY
Practice address
179 Belle Mead Rd
Department of Neurology
East Setauket, NY 11733-3456
Phone
(631) 444-1985
NPI assigned
May 28, 2008
Last updated
Apr 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 240647 NY Primary

Addresses

Primary practice location

179 Belle Mead Rd
Department of Neurology
East Setauket, NY 11733-3456

Mailing address

HSC T12-020
Stony Brook University Hospital
Stony Brook, NY 11794-8121
Phone (631) 444-2599

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JILL.MILLER-HORN@DIRECTSTONYBROOKMEDICINE.EDU

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
I20090708000284 NY Practitioner - NeurologyPractitioner - Pediatric Medicine 7618028481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pediatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-2599

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (631) 638-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo CurrentSince Jul 1, 2009 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients

Locations

179 N Belle Mead Rd
East Setauket, NY 11733
Phone (631) 444-1985

181 N Belle Mead Rd
Ste 6
East Setauket, NY 11733
Phone (631) 444-4234

4 Smith Haven Mall
Ste 105
Lake Grove, NY 11755

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Hsc T12020
Stony Brook, NY 11794
Phone (202) 687-2184

Networks

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

Interoperability endpoints

  • Direct secure messaging: jill.miller-horn@directstonybrookmedicine.edu
  • Direct secure messaging: jill.miller-horn1@direct.stonybrookmedicine.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649462400000",
    "number": "1639337504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HSC T12-020",
            "address_2": "STONY BROOK UNIVERSITY HOSPITAL",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948121",
            "telephone_number": "631-444-2599",
            "fax_number": "631-444-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 BELLE MEAD RD",
            "address_2": "DEPARTMENT OF NEUROLOGY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333456",
            "telephone_number": "631-444-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER-HORN",
        "first_name": "JILL",
        "middle_name": "WALLIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2022-04-09",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "240647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JILL.MILLER-HORN@DIRECTSTONYBROOKMEDICINE.EDU",
            "affiliation": "N",
            "address_1": "179 Belle Mead Rd",
            "address_2": "Department of Neurology",
            "city": "East Setauket",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117333456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.