Organization Active NPI

Ricardo a. Miller Nurse Practitioner in Psychiatry, PLLC

  • Nurse Practitioner
  • Valley Stream, NY
National Provider Identifier
1699340414
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
RICARDO A. MILLER NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Practice address
115 S Corona Ave
Valley Stream, NY 11580-6217
Phone
(516) 568-7032
NPI assigned
May 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Ricardo Miller
Title
Owner
Phone
(516) 568-7032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

115 S Corona Ave
Valley Stream, NY 11580-6217

Mailing address

115 S Corona Ave
Valley Stream, NY 11580-6217
Phone (516) 568-7032

Other identifiers 1

IdentifierTypeStateIssuer
02866306MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1699340414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S CORONA AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806217",
            "telephone_number": "516-568-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S CORONA AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806217",
            "telephone_number": "516-568-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICARDO A. MILLER NURSE PRACTITIONER IN PSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-568-7032"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02866306",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.