Active NPI
Elisheva B Miller, PHYSICIAN ASSISTANT
- Physician Assistant
- Lakewood, NJ
National Provider Identifier
1669409348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00532200
- Practice address
- 1771 Madison Ave
Lakewood, NJ 08701-1242 - Phone
- (732) 534-8073
- Fax
- (732) 364-3559
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00532200 | NJ | Primary |
Addresses
Primary practice location
1771 Madison Ave
Lakewood, NJ 08701-1242
Mailing address
1771 Madison Ave
Lakewood, NJ 08701-1242
Phone (732) 534-8073
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
27 S Cooks Bridge Rd
Suite 2 14
Jackson, NJ 08527-2443
Phone (718) 853-7546
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011247 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakewood Resource and Referral Center Inc | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Lakewood, NJ
- NPI 1083748297
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1669409348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1771 MADISON AVE",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087011242",
"telephone_number": "732-534-8073",
"fax_number": "732-364-3559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1771 MADISON AVE",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087011242",
"telephone_number": "732-534-8073",
"fax_number": "732-364-3559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ELISHEVA",
"middle_name": "B",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00532200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.