Individual provider Active NPI

Mark Daniel Miller, APRN, AGACNP

  • Acute Care Nurse Practitioner
  • West Haven, CT
National Provider Identifier
1639895691
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
12208 Issued in CT
Practice address
1 Cellini PL Ste 102
West Haven, CT 06516-1666
Phone
(203) 932-6481
NPI assigned
Oct 12, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 33688 TN
Adult Health Nurse Practitioner 363LA2200X 12208 CT
Gerontology Nurse Practitioner 363LG0600X 12208 CT
Acute Care Nurse Practitioner 363LA2100X 12208 CT Primary

Addresses

Primary practice location

1 Cellini PL Ste 102
West Haven, CT 06516-1666

Mailing address

124 Warren Ave
Mystic, CT 06355-2131
Phone (860) 460-6814

Other practice location 1

1104 16th Ave S
Nashville, TN 37212-2305
Phone (615) 455-3903

Other practice location 2

106 Valeria St
Nashville, TN 37210-5014
Phone (717) 460-1625

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.miller@xdr.hhchealthdirect.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20250123002076 CT Practitioner - Nurse Practitioner 8123557923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HHC Physician Services PLLCGroup PAC ID 9537573357, 140 clinicians
Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians

Practice addresses (Care Compare)

1 Cellini PL
Suite 102
West Haven, CT 06516-1666
Phone (203) 932-6481

20 Babcock Ave
Suite 26
Plainfield, CT 06374-1226
Phone (312) 529-8976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
33688TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HHC Physician Services, PLLC CurrentSince Feb 3, 2025 Accepting new patients
HHC Physician Services, PLLC Acute Care Current Accepting new patients
Comprehensive Rehab Consultants PLLC CurrentSince Oct 15, 2024 Accepting new patients
HHC Physician Services, PLLC CurrentSince Feb 3, 2025 Accepting new patients

Locations

78 Viets St
New London, CT 06320
Phone (860) 447-1416

250 Indian River Rd
Ste 300
Orange, CT 06477
Phone (203) 738-7700

20 Babcock Ave
Plainfield, CT 06374
Phone (860) 230-0836

20 Babcock Ave
Ste 26
Plainfield, CT 06374
Phone (312) 529-8976

1 Emily Way
West Hartfrd, CT 06107
Phone (860) 561-7022

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

Organizations & group practices 4

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": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1639895691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 WARREN AVE",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552131",
            "telephone_number": "860-460-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CELLINI PL STE 102",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161666",
            "telephone_number": "203-932-6481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1104 16th Ave S",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372122305",
            "country_code": "US",
            "telephone_number": "615-455-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Valeria St",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372105014",
            "country_code": "US",
            "telephone_number": "717-460-1625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARK",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "APRN, AGACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "33688",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "12208",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "12208",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "12208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.miller@xdr.hhchealthdirect.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1 Cellini Pl Ste 102",
            "city": "West Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065161666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.