Active NPI
Tricia D Miller, P.A.
- Physician Assistant
- Plattsburgh, NY
National Provider Identifier
1720008147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0175371
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 292485400 | Medicaid | FL |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3689 | FL | MD | Marriage & Family Therapist |
| 0175371 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JDS Medical Services PC | Current | Accepting new patients | |
| Town & Country Emergency Physicians LLC | Past | Accepting new patients | |
| Jonathan Beach DO PLLC | Past | 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.
-
- Geriatric Medicine (Internal Medicine) Physician
- Brooklyn, NY
- NPI 1255067955
-
- Geriatric Medicine (Internal Medicine) Physician
- Princess Anne, MD
- NPI 1871955807
NY
-
- Primary Care Clinic/Center
- Plattsburgh, NY
- NPI 1881078079
-
- Skilled Nursing Facility
- Elizabethtown, NY
- NPI 1093144024
-
- Urgent Care Clinic/Center
- Plattsburgh, NY
- NPI 1104023910
-
- Emergency Medicine Physician
- Tampa, FL
- NPI 1629024088
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.