Individual provider Active NPI

Tricia D Miller, P.A.

  • Physician Assistant
  • Plattsburgh, NY
National Provider Identifier
1720008147
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0175371 Issued in NY
Practice address
79 Hammond LN
Suite 2
Plattsburgh, NY 12901-2008
Phone
(518) 563-5900
Fax
(518) 563-5903
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0175371 NY Primary

Addresses

Primary practice location

79 Hammond LN
Suite 2
Plattsburgh, NY 12901-2008

Mailing address

79 Hammond LN
Suite 2
Plattsburgh, NY 12901-2008
Phone (518) 563-5900

Other identifiers 1

IdentifierTypeStateIssuer
292485400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317002730 NY Practitioner - Physician Assistant 3779588819 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3689FLMDMarriage & Family Therapist
0175371NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
JDS Medical Services PC CurrentSince Dec 22, 2025 Accepting new patients
Town & Country Emergency Physicians LLC Past Accepting new patients
Jonathan Beach DO PLLC PastSince Feb 1, 2007 Accepting new patients
Essex Operations Associates LLC Past Accepting new patients
Beach Medical Services Past Accepting new patients

Locations

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

Organizations & group practices 7

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1720008147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 HAMMOND LN",
            "address_2": "SUITE 2",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012008",
            "telephone_number": "518-563-5900",
            "fax_number": "518-563-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 HAMMOND LN",
            "address_2": "SUITE 2",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012008",
            "telephone_number": "518-563-5900",
            "fax_number": "518-563-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TRICIA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0175371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292485400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.