Active NPI
Ivy Medical Group PLLC
- Emergency Medicine Physician
- New York, NY
National Provider Identifier
1700558798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- IVY MEDICAL GROUP PLLC
- Practice address
- 885 3Rd Ave FL 28
New York, NY 10022-4834 - Phone
- (929) 650-3990
- Fax
- (929) 996-6230
- NPI assigned
- Sep 29, 2021
- Last updated
- Apr 23, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Faige Miller
- Title
- Authorized Official
- Phone
- (718) 534-0689
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
885 3Rd Ave FL 28
New York, NY 10022-4834
Mailing address
885 3Rd Ave FL 28
New York, NY 10022-4834
Phone (929) 650-3990
Other practice location 1
100 Chambers St
Cumberland, RI 02864-7724
Phone (929) 650-3990
Other practice location 2
1150 W Dorothy LN
Kettering, OH 45409-1305
Phone (929) 650-3990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV, NY, FL, PA, MD, NH, DE, ME, VT, CT, OH, RI, MO, AL, TN, VA, NC, DC, IL, KY, MS, WA, TX, LA, NM, SD, AR, MA, CA
Enrollment records 29
National Provider Directory
National Provider DirectoryLocations
1551 Sawgrass Corporate Pkwy
Ste 410
Sunrise, FL 33323
2 Skillman St
Ste 213
Brooklyn, NY 11205
Phone (347) 534-8640
885 3rd Ave
New York, NY 10022
Phone (212) 906-1200
Practitioners & affiliated clinicians
Practitioners 188
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Gerontology Nurse Practitioner
- Rochester, NY
- NPI 1245209824
CT, FL, ME, NH, RI, VT
-
- Family Nurse Practitioner
- New York, NY
- NPI 1043583032
CT, DE, ME, NH, RI, TN, VT
-
- Mental Health Counselor
- Newburgh, NY
- NPI 1982851093
-
- Psychiatric/Mental Health Nurse Practitioner
- Las Vegas, NV
- NPI 1043648140
IL
-
- Family Nurse Practitioner
- Brooksville, FL
- NPI 1629665955
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632873600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776902400000",
"number": "1700558798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "885 3RD AVE FL 28",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100224834",
"telephone_number": "929-650-3990",
"fax_number": "929-996-6230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "885 3RD AVE FL 28",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100224834",
"telephone_number": "929-650-3990",
"fax_number": "929-996-6230"
}
],
"practiceLocations": [
{
"address_1": "100 Chambers St",
"address_purpose": "LOCATION",
"city": "Cumberland",
"state": "RI",
"postal_code": "028647724",
"country_code": "US",
"telephone_number": "929-650-3990",
"fax_number": "929-996-6230",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1150 W DOROTHY LN",
"address_purpose": "LOCATION",
"city": "KETTERING",
"state": "OH",
"postal_code": "454091305",
"country_code": "US",
"telephone_number": "929-650-3990",
"fax_number": "929-996-6230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "IVY MEDICAL GROUP PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-29",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "FAIGE",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "718-534-0689"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.