Individual provider Active NPI

Stanley I Miller, DC

  • Chiropractor
  • Brooklyn, NY
National Provider Identifier
1679611644
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X003429-1 Issued in NY
Practice address
4405 16TH Ave
Brooklyn, NY 11204
Phone
(718) 853-4927
Fax
(718) 853-0629
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X003429-1 NY Primary

Addresses

Primary practice location

4405 16TH Ave
Brooklyn, NY 11204

Mailing address

4405 16TH Ave
Brooklyn, NY 11204
Phone (718) 853-4927

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120203000120 NY Practitioner - Chiropractic 1850558800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4405 16TH Ave
Brooklyn, NY 11204-1013
Phone 84542532321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X003429-1NYMDChiropractor
003429NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stanley Miller, D.C.P.C. Chiropractor CurrentSince Jan 1, 2012 Accepting new patients
David Mahgerefteh Past Accepting new patients
Shifra Ullman Family Health NP PastSince Feb 4, 2024 Accepting new patients

Locations

4405 16th Ave
Brooklyn, NY 11204
Phone (718) 633-8662

Organizations & group practices 3

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1679611644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11204",
            "telephone_number": "718-853-4927",
            "fax_number": "718-853-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11204",
            "telephone_number": "718-853-4927",
            "fax_number": "718-853-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STANLEY",
        "middle_name": "I",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X003429-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.