Individual provider Active NPI

Marilyn Miller, NP

  • Family Nurse Practitioner
  • Hudson, NY
National Provider Identifier
1649200585
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F333618 Issued in NY
Practice address
71 Prospect Ave
Suite 130
Hudson, NY 12534-2907
Phone
(518) 697-3540
Fax
(518) 697-3551
NPI assigned
Jul 4, 2006
Last updated
Jul 29, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F333618 NY Primary

Addresses

Primary practice location

71 Prospect Ave
Suite 130
Hudson, NY 12534-2907

Mailing address

PO Box 2000
Hudson, NY 12534-2000
Phone (518) 828-8363

Other identifiers 1

IdentifierTypeStateIssuer
02406751MedicaidNY

Other names 1

  • Marilyn Martin Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100605000068 NY Practitioner - Nurse Practitioner 7517097389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Memorial HospitalGroup PAC ID 5092709410, 171 clinicians

Practice addresses (Care Compare)

2827 US Route 9
Valatie, NY 12184-0785
Phone (518) 828-8051

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F333618NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Memorial Hospital CurrentSince Nov 19, 1993 Accepting new patients
Columbia Memorial Hospital CurrentSince Nov 19, 1993 Accepting new patients

Locations

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

71 Prospect Ave
#H
Hudson, NY 12534
Phone (518) 392-6650

71 Prospect Ave
Ste 130
Hudson, NY 12534
Phone (518) 697-3540

2827 US Highway 9
Valatie, NY 12184
Phone (518) 828-7601

Interoperability endpoints

  • Direct secure messaging: mmiller100679@albanymed.direct-ci.com

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1649200585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342000",
            "telephone_number": "518-828-8363",
            "fax_number": "518-697-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 PROSPECT AVE",
            "address_2": "SUITE 130",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342907",
            "telephone_number": "518-697-3540",
            "fax_number": "518-697-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARILYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02406751",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "MARTIN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hudson, NY

Sources for this page

Verify at the official NPI Registry.