Individual provider Active NPI

Kimberly Cybil Miller, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1669752549
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
013666-1 Issued in NY
Practice address
3399 Winton Rd S
Rochester, NY 14623-3057
Phone
(585) 334-6000
NPI assigned
Aug 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 013666-1 NY Primary

Addresses

Primary practice location

3399 Winton Rd S
Rochester, NY 14623-3057

Mailing address

36 Hubbard Dr
North Chili, NY 14514-1004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141021001443 NY Practitioner - Qualified Speech Language Pathologist 7618198458 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
013666-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Association of the Rochester Area, Inc. CurrentSince Jul 30, 2014 Accepting new patients
Finger Lakes United Cerebral Palsy, Inc. CurrentSince May 9, 2022 Accepting new patients

Locations

5415 N Bloomfield Rd
Canandaigua, NY 14424
Phone (585) 394-1190

731 Pre Emption Rd
Geneva, NY 14456
Phone (315) 789-6828

3399 Winton Rd S
Rochester, NY 14623

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": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1669752549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HUBBARD DR",
            "city": "NORTH CHILI",
            "state": "NY",
            "postal_code": "145141004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 WINTON RD S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233057",
            "telephone_number": "585-334-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KIMBERLY",
        "middle_name": "CYBIL",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "013666-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.